DOCSLIB.ORG

Transaminase Elevations During Treatment of Chronic Hepatitis B Infection: Safety Considerations and Role in Achieving Functional Cure

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Transaminase Elevations During Treatment of Chronic Hepatitis B Infection: Safety Considerations and Role in Achieving Functional Cure viruses Review Transaminase Elevations during Treatment of Chronic Hepatitis B Infection: Safety Considerations and Role in Achieving Functional Cure Andrew Vaillant Replicor Inc., 6100 Royalmount Avenue, Montreal, QC H4P 2R2, Canada; [email protected] Abstract: While current therapies for chronic HBV infection work well to control viremia and stop the progression of liver disease, the preferred outcome of therapy is the restoration of immune control of HBV infection, allowing therapy to be removed while maintaining effective suppression of infection and reversal of liver damage. This “functional cure” of chronic HBV infection is characterized by the absence of detectable viremia (HBV DNA) and antigenemia (HBsAg) and normal liver function and is the goal of new therapies in development. Functional cure requires removal of the ability of infected cells in the liver to produce the hepatitis B surface antigen. The increased observation of transaminase elevations with new therapies makes understanding the safety and therapeutic impact of these flares an increasingly important issue. This review examines the factors driving the appearance of transaminase elevations during therapy of chronic HBV infection and the interplay of these factors in assessing the safety and beneficial nature of these flares. Keywords: transaminase flare; hepatitis B; functional cure; HBsAg Citation: Vaillant, A. Transaminase Elevations during Treatment of 1. Introduction Chronic Hepatitis B Infection: Safety Exposure to the hepatitis B virus (HBV) causes a predominantly hepatotropic infection, Considerations and Role in Achieving which in its acute state commonly causes liver inflammation and dysfunction and in its Functional Cure. Viruses 2021, 13, 745. chronic state fibrosis, cirrhosis and hepatocellular carcinoma (HCC) [1–3]. While >80% https://doi.org/10.3390/v13050745 of people infected with HBV achieve immune control and self-resolve their infection, reactivation of latent infection [4] in the livers of these individuals can still occur with Academic Editor: Carla S. Coffin immunosuppressive therapy [5,6]. Unfortunately, HBV infection remains chronic in more than 292 million people worldwide [7] and is responsible for 870,000 deaths annually [8]. Received: 31 March 2021 This chronic infection results from (1) the inhibition of the immune response to HBV via Accepted: 22 April 2021 the maintenance of abundant circulating HBsAg by the production of a large excess of Published: 23 April 2021 non-infectious subviral particles (SVP) over virions [9], (2) the ability of the HBV genome to form a closed covalent circular DNA (cccDNA) “minichromosome” that can reside inside Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in the nucleus of infected cells in an inactive “latent” state [10] and (3) the integration of HBV published maps and institutional affil- DNA into the chromosomes of liver cells [11,12], which progresses with continued chronic iations. infection, becoming a significant source of SVP [9,13–15]. The current challenge in the treatment of chronic HBV infection is to restore immune control allowing suppression of viral infection to be maintained in the absence of therapy, thereby allowing liver damage to regress and the risk of developing hepatocellular carci- noma to decline. This “functional cure” of chronic HBV infection requires the reconstitution Copyright: © 2021 by the author. of immune control and is characterized by the absence of circulating HBV surface antigen Licensee MDPI, Basel, Switzerland. (HBsAg) without therapy [16–20]. Since HBsAg is almost entirely derived from SVP [9], This article is an open access article distributed under the terms and establishing a functional cure of HBV infection requires not only clearing SVP from the conditions of the Creative Commons blood but removing the SVP producing capacity in the liver by the silencing of cccDNA Attribution (CC BY) license (https:// and the removal of hepatocytes with integrated HBV DNA [14,15]. creativecommons.org/licenses/by/ Since the clearance of hepatocytes with integrated HBV DNA from the liver is a 4.0/). critical milestone in achieving functional cure, the resulting damage in the liver is also Viruses 2021, 13, 745. https://doi.org/10.3390/v13050745 https://www.mdpi.com/journal/viruses Viruses 2021, 13, 745 2 of 18 Viruses 2021, 13, 745 Since the clearance of hepatocytes with integrated HBV DNA from the liver is a2 crit- of 17 ical milestone in achieving functional cure, the resulting damage in the liver is also ex- pected to result in elevations in serum concentrations of liver enzymes. This creates a clin- ical challenge as liver enzyme flares are known to occur with a variety of other liver dis- expectedeases where to resultthey are in elevationsassociated with in serum hepatoxi concentrationscity. Given ofthe liver current enzymes. focus on This achieving creates aa clinicalfunctional challenge cure of asHBV liver with enzyme new therapeutic flares are known agents, to this occur review with aexplores variety how of other liver liver en- diseaseszyme flares where during they the are associatedtreatment withof chronic hepatoxicity. HBV infection Given the affect current liver focus function on achieving and the apotential functional utility cure of ofthese HBV flares with to new predict therapeutic positive therapeutic agents, this outcomes. review explores how liver enzyme flares during the treatment of chronic HBV infection affect liver function and the potential2. Distribution utility of HBV these Infection flares to predict in the positiveLiver therapeutic outcomes. 2. DistributionDuring acute of HBV(initial) Infection infection, in theHBV Liver infection appears infrequently in individual hepatocytesDuring where acute (initial)HBsAg is infection, located primarily HBV infection in the appearscytoplasm infrequently [21]. These incells individual presum- hepatocytesably also contain where replicating HBsAg is virus. located Transition primarily to in chronic the cytoplasm infection [ 21(Figure]. These 1) appears cells presum- to be ablyaccompanied also contain by translocation replicating virus. of HBsAg Transition to the to chroniccell margins infection [21]. (FigureThe number1) appears of cells to be in accompaniedan initially infected by translocation liver is unknown, of HBsAg as tosymptoms the cell margins of acute [ 21infection]. The numberare considered of cells into anoccur initially weeks infected to months liver after is unknown, the initial as infection symptoms event. of acuteIn chronic infection infection, are considered the bulk toof occurinfected weeks cells toin monthsthe liverafter are hepatocytes, the initial infection but infection event. is Inalso chronic present infection, to a lesser the extent bulk ofin infectedthe bile duct cells epithelium in the liver as are well hepatocytes, as endothelial but infection and smooth is also muscle present cells to aof lesser hepatic extent blood in thevessels bile [22]. duct Scattered epithelium HBsAg as well positive as endothelial hepatocytes and are smooth accompanied muscle cells by HBcAg of hepatic positivity blood vesselsapproximately [22]. Scattered 70% of HBsAgthe time, positive and HBsAg hepatocytes is found are both accompanied in the cytoplasm by HBcAg and positivityat the cell approximatelymargin [21,23]. 70%With of the the transition time, and HBsAgfrom H isBeAg found positive both in to the HBeAg cytoplasm negative and atinfection, the cell marginHBsAg distribution [21,23]. With becomes the transition mainly fromdistribut HBeAged in positiveclusters of to hepatocytes HBeAg negative predominantly infection, HBsAgin the cytoplasm distribution [24], becomes in which mainly HBcAg distributed is less frequently in clusters detected of hepatocytes (Figure 1). predominantly This clustered inHBsAg+, the cytoplasm HBcAg- [24 pattern], in which persists HBcAg in isinactive less frequently HBV infection detected with (Figure mostly1). This cytoplasmic clustered HBsAg+,HBsAg localization HBcAg- pattern [21,23]. persists These inpatterns inactive are HBV consistent infection with with the mostly progressive cytoplasmic establish- HB- sAgment localization of HBV infection [21,23]. in These the liver patterns during are the consistent natural history with the of progressive HBV infection, establishment with tran- ofsition HBV from infection individual in the hepatocytes liver during producing the natural virus history and of SVP HBV to infection,clusters of with infected transition cells, fromwhich individual include hepatocytes hepatocytes containing producing only virus integrated and SVP to HBV clusters DNA of and infected producing cells, which only includeSVP. hepatocytes containing only integrated HBV DNA and producing only SVP. FigureFigure 1. Distribution 1. Distribution of ofinfection infection in inthe the liver liver during during the the course course of ofHBV HBV infection. infection. In chronic HBV infection, numerous studies have confirmed the heterogenous pattern of infected hepatocytes in chronic HBV infection (Figure1) where infection is spread intermittently throughout the liver in patches comprised entirely of infected cells [21,23–28] Viruses 2021, 13, 745 3 of 17 or in sparsely infected regions [21,24,25,27,29,30]. In many instances, HBsAg expression is detected in cells devoid of HBV DNA or HBcAg [26,28,31–33] (Figure1), which signals the presence of cells containing integrated HBV DNA, producing HBsAg efficiently (as SVP) but not HBV pgRNA (and HBV DNA) or
Load more

Recommended publications
  • Causes and Evaluation of Mildly Elevated Liver Transaminase Levels ROBERT C
    Causes and Evaluation of Mildly Elevated Liver Transaminase Levels ROBERT C. OH, LTC, MC, USA, and THOMAS R. HUSTEAD, LTC, MC, USA Tripler Army Medical Center Family Medicine Residency Program, Honolulu, Hawaii Mild elevations in levels of the liver enzymes alanine transaminase and aspartate transaminase are commonly dis- covered in asymptomatic patients in primary care. Evidence to guide the diagnostic workup is limited. If the history and physical examination do not suggest a cause, a stepwise evaluation should be initiated based on the prevalence of diseases that cause mild elevations in transaminase levels. The most common cause is nonalcoholic fatty liver disease, which can affect up to 30 percent of the population. Other common causes include alcoholic liver disease, medication- associated liver injury, viral hepatitis (hepatitis B and C), and hemochromatosis. Less common causes include α1-antitrypsin deficiency, autoimmune hepatitis, and Wilson disease. Extrahepatic conditions (e.g., thyroid disorders, celiac disease, hemolysis, muscle disorders) can also cause elevated liver transaminase levels. Initial testing should include a fasting lipid profile; measurement of glucose, serum iron, and ferritin; total iron-binding capacity; and hepa- titis B surface antigen and hepatitis C virus antibody testing. If test results are normal, a trial of lifestyle modification with observation or further testing for less common causes is appropriate. Additional testing may include ultrasonog- raphy; measurement of α1-antitrypsin and ceruloplasmin; serum protein electrophoresis; and antinuclear antibody, smooth muscle antibody, and liver/kidney microsomal antibody type 1 testing. Referral for further evaluation and possible liver biopsy is recommended if transaminase levels remain elevated for six months or more.
    [Show full text]
  • Gamma Glutamyl Transferase (GGT) NCD 190.32
    Medicare National Coverage Determination (NCD) Policy TRANSFERASE GAMMA GLUTAMYL Summary: Gamma Glutamyl Transferase (GGT) NCD 190.32 The terms of Medicare National Coverage Determinations (NCDs) are binding on all fee-for-service (Part A/B) Medicare Administrative Contractors (MACs) and Medicare Advantage (MA) plans. NCDs are not binding, however, on Medicaid and other governmental payers, nor are they binding on commercial payers in their non-MA lines of business. Item/Service Description* Gamma Glutamyl Transferase (GGT) is an intracellular enzyme that appears in blood following leakage from cells. Renal tubules, liver, and pancreas contain high amounts, although the measurement of GGT in serum is almost always used for assessment of hepatobiliary function. Unlike other enzymes which are found in heart, skeletal muscle, and intestinal mucosa as well as liver, the appearance of an elevated level of GGT in serum is almost always the result of liver disease or injury. It is specifically useful to differentiate elevated alkaline phosphatase levels when the source of the alkaline phosphatase increase (bone, liver, or placenta) is unclear. The combination of high alkaline phosphatase and a normal GGT does not, however, rule out liver disease completely. As well as being a very specific marker of hepatobiliary function, GGT is also a very sensitive marker for hepatocellular damage. Abnormal concentrations typically appear before elevations of other liver enzymes or bilirubin are evident. Obstruction of the biliary tract, viral infection (e.g., hepatitis, mononucleosis), metastatic cancer, exposure to hepatotoxins (e.g., organic solvents, drugs, alcohol), and use of drugs that induce microsomal enzymes in the liver (e.g., cimetidine, barbiturates, phenytoin, and carbamazepine) all can cause a moderate to marked increase in GGT serum concentration.
    [Show full text]
  • Como As Enzimas Agem?
    O que são enzimas? Catalizadores biológicos - Aceleram reações químicas específicas sem a formação de produtos colaterais PRODUTO SUBSTRATO COMPLEXO SITIO ATIVO ENZIMA SUBSTRATO Características das enzimas 1 - Grande maioria das enzimas são proteínas (algumas moléculas de RNA tem atividade catalítica) 2 - Funcionam em soluções aquosas diluídas, em condições muito suaves de temperatura e pH (mM, pH neutro, 25 a 37oC) Pepsina estômago – pH 2 Enzimas de organismos hipertermófilos (crescem em ambientes quentes) atuam a 95oC 3 - Apresentam alto grau de especificidade por seus reagentes (substratos) Molécula que se liga ao sítio ativo Região da enzima e que vai sofrer onde ocorre a a ação da reação = sítio ativo enzima = substrato 4 - Peso molecular: varia de 12.000 à 1 milhão daltons (Da), são portanto muito grandes quando comparadas ao substrato. 5 - A atividade catalítica das Enzimas depende da integridade de sua conformação protéica nativa – local de atividade catalítica (sitio ativo) Sítio ativo e toda a molécula proporciona um ambiente adequado para ocorrer a reação química desejada sobre o substrato A atividade de algumas enzimas podem depender de outros componentes não proteicos Enzima ativa = Holoenzimas Parte protéica das enzimas + cofator Apoenzima ou apoproteína •Íon inorgânico •Molécula complexa (coenzima) Covalentemente ligados à apoenzima GRUPO PROSTÉTICO COFATORES Elemento com ação complementar ao sitio ativo as enzimas que auxiliam na formação de um ambiente ideal para ocorrer a reação química ou participam diretamente dela
    [Show full text]
  • Relationship of Liver Enzymes to Insulin Sensitivity and Intra-Abdominal Fat
    Diabetes Care Publish Ahead of Print, published online July 31, 2007 Relationship of Liver Enzymes to Insulin Sensitivity and Intra-abdominal Fat Tara M Wallace MD*, Kristina M Utzschneider MD*, Jenny Tong MD*, 1Darcy B Carr MD, Sakeneh Zraika PhD, 2Daniel D Bankson MD, 3Robert H Knopp MD, Steven E Kahn MB, ChB. *Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System 1Obstetrics and Gynecology, University of Washington, Seattle, WA 2Pathology and Laboratory Medicine, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA 3Harborview Medical Center, University of Washington, Seattle, WA Running title: Liver enzymes and insulin sensitivity Correspondence to: Steven E. Kahn, M.B., Ch.B. VA Puget Sound Health Care System (151) 1660 S. Columbian Way Seattle, WA 98108 Email: [email protected] Received for publication 18 August 2006 and accepted in revised form 29 June 2007. 1 Copyright American Diabetes Association, Inc., 2007 Liver enzymes and insulin sensitivity ABSTRACT Objective: To determine the relationship between plasma liver enzyme concentrations, insulin sensitivity and intra-abdominal fat (IAF) distribution. Research Design and Methods: Plasma gamma-glutamyl transferase (GGT), aspartate transaminase (AST), alanine transaminase (ALT) levels, insulin sensitivity (SI), IAF and subcutaneous fat (SCF) areas were measured on 177 non-diabetic subjects (75M/102, 31-75 2 -5 years) with no history of liver disease. Based on BMI (< or ≥27.5 kg/m ) and SI (< or ≥7.0x10 min-1 pM-1) subjects were divided into lean insulin sensitive (LIS, n=53), lean insulin resistant (LIR, n=60) and obese insulin resistant (OIR, n=56) groups.
    [Show full text]
  • GFAT and PFK Genes Show Contrasting Regulation of Chitin
    www.nature.com/scientificreports OPEN GFAT and PFK genes show contrasting regulation of chitin metabolism in Nilaparvata lugens Cai‑Di Xu1,3, Yong‑Kang Liu2,3, Ling‑Yu Qiu2, Sha‑Sha Wang2, Bi‑Ying Pan2, Yan Li2, Shi‑Gui Wang2 & Bin Tang2* Glutamine:fructose‑6‑phosphate aminotransferase (GFAT) and phosphofructokinase (PFK) are enzymes related to chitin metabolism. RNA interference (RNAi) technology was used to explore the role of these two enzyme genes in chitin metabolism. In this study, we found that GFAT and PFK were highly expressed in the wing bud of Nilaparvata lugens and were increased signifcantly during molting. RNAi of GFAT and PFK both caused severe malformation rates and mortality rates in N. lugens. GFAT inhibition also downregulated GFAT, GNPNA, PGM1, PGM2, UAP, CHS1, CHS1a, CHS1b, Cht1-10, and ENGase. PFK inhibition signifcantly downregulated GFAT; upregulated GNPNA, PGM2, UAP, Cht2‑4, Cht6‑7 at 48 h and then downregulated them at 72 h; upregulated Cht5, Cht8, Cht10, and ENGase; downregulated Cht9 at 48 h and then upregulated it at 72 h; and upregulated CHS1, CHS1a, and CHS1b. In conclusion, GFAT and PFK regulated chitin degradation and remodeling by regulating the expression of genes related to the chitin metabolism and exert opposite efects on these genes. These results may be benefcial to develop new chitin synthesis inhibitors for pest control. Chitin is a linear polymer composed of N-acetylglucosamine units connected by β-1, 4-glycoside bonds and is the second most abundant biopolymer in nature. It is widely distributed in fungi, nematodes, and arthropods1. In insects, chitin is a major component of the exoskeleton, trachea, and the peritrophic matrix that lines the midgut epithelium1–4.
    [Show full text]
  • Alanine Transaminase Assay (ALT) Catalog #8478 100 Tests in 96-Well Plate
    Alanine Transaminase Assay (ALT) Catalog #8478 100 Tests in 96-well plate Product Description Alanine Aminotransferase (ALT), also known as serum glutamic-pyruvic transaminase (SGPT), catalyzes the reversible transfer of an amino group from alanine to α-ketoglutarate. The products of this transamination reaction are pyruvate and glutamate. ALT is found primarily in liver and serum, but occurs in other tissues as well. Significantly elevated serum ALT levels often suggest the existence of medical problems, such as hepatocellular injury, hepatitis, diabetes, bile duct problem and myopathy. This colorimetric assay is based on the oxidization of NADH to NAD in the presence of pyruvate and lactate dehydrogenase. The ALT activity is determined by assaying the rate of NADH oxidation, which is proportional to the reduction in absorbance at 340nm over time (ΔOD340nm/min). Kit Components Cat. No. # of vials Reagent Quantity Storage 8478a 1 Assay buffer 10 mL -20°C 8478b 1 ALT standard 10 µL -20°C 8478c 1 Substrate mix 1.0 mL -20°C 8478d 1 Cofactor 0.8 mL -20°C 8478e 1 Enzyme 0.2 mL -80°C Product Use The ALT kit measures the alanine transaminase activity of different types of samples, such as serum, plasma and tissues. ALT is for research use only. It is not approved for human or animal use, or for application in in vitro diagnostic procedures. Quality Control Serially diluted alanine transaminase solutions with concentrations ranging from 0.03125 to 1.0 U/mL are measured with the ScienCell™ Alanine Transaminase Assay kit. The decrease in OD340nm is monitored as a function of time (Figure 1) and the resulting standard of ∆OD340nm/min vs alanine transaminase activity are plotted (Figure 2).
    [Show full text]
  • Pyridoxine (Pyridoxamine) 5'-Phosphate Oxidase In
    PYRIDOXINE (PYRIDOXAMINE) 5’-PHOSPHATE OXIDASE IN ARABIDOPSIS THALIANA Except where reference is made to the work of others, the work described in this dissertation is my own or was done in collaboration with my advisory committee. This dissertation does not include proprietary or classified information. Yuying Sang Certificate of Approval: Robert D. Locy Narendra K. Singh, Chair Professor Professor Biological Sciences Biological Sciences Joe H. Cherry Joanna Wysocka-Diller Emeritus Professor Associate Professor Biological Sciences Biological Sciences Fenny Dane George T. Flowers Professor Dean Horticulture Graduate School PYRIDOXINE (PYRIDOXAMINE) 5’-PHOSPHATE OXIDASE IN ARABIDOPSIS THALIANA Yuying Sang A Dissertation Submitted to the Graduate Faculty of Auburn University in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Auburn, Alabama December 19, 2008 PYRIDOXINE (PYRIDOXAMINE) 5’-PHOSPHATE OXIDASE IN ARABIDOPSIS THALIANA Yuying Sang Permission is granted to Auburn University to make copies of this dissertation at its discretion, upon request of individuals of institutions and at their expense. The author reserves all publication right. Signature of Author Date of Graduation iii VITA Yuying Sang, daughter of Shiqing Sang and Guilan Wang, was born on January 7, 1975, in Chiping, Shandong, People’s Republic of China. She received the Bachelor of Science degree in Biology in July 1997 from Shandong Normal University and entered the Graduate School of Kunming Institute of Botany, Chinese Academy of Sciences. In the July of 2000, she graduated with a Master of Science degree in Botany and joined East China University of Science and Technology as a lab manager in the Department of Bioengineering.
    [Show full text]
  • Variants of Phosphohexose Isomerase in Gastrointestinal And
    [CANCER RESEARCH 48. 2998-3001, June, 1988] Variants of Phosphohexose Isomerase in Gastrointestinal and Mammary Carcinoma: Isoelectric Focusing Patterns of Normal and Tumor Tissues Derived from Surgical Specimens of the Same Patient1 Matthias Baumann, Damián Jezussek, Ralf-Torsten Richter, and Karl Brand2 Institute of Biochemistry, Medical Faculty, University of Erlangen-Nuremberg, Federal Republic of Germany ABSTRACT H2PO4 H2O, 5; MgSO4 7H2O,0.77; Krebs saline buffer: H2O, 1:4; pH 7.5). The occurrence of charge variants of phosphohexose isómeras? was Then the homogenate was sonicated by 6 pulses of 10 s each at 50 elucidated in cancerous and, for comparison, in noncancerous tissues W with cooling intervals of 1 min to make sure that the temperature of the preparation remained below 10'C. Subsequently, the extract was obtained from the same organ. Surgical specimens from 35 patients with gastrointestinal and mammary carcinoma were studied by means of the rehomogenized and centrifuged at 12,000 x g for 10 min. The super isoelectric focusing (IEF) technique. Differences in the IEF pattern could natant was dialyzed against 1% glycine buffer, pH 7.5, overnight at 4'C. LKB Multiplier 2117, LKB Power Supply Unit 2103, and Servalyt be demonstrated in 90% of the patients with gastric cancer. Correspond ing values for the patients with colorectal and mammary carcinoma were Precotes, pH 3-10, were used for the isoelectric focusing experiments. 50 and 73%, respectively. Almost all normal specimens proved to be A Julabo Paratherm FT20p electronic thermostat served to cool the plate to 4'C during the run. monomorphic, revealing only the major basic band with a pi of 9.1.
    [Show full text]
  • 12) United States Patent (10
    US007635572B2 (12) UnitedO States Patent (10) Patent No.: US 7,635,572 B2 Zhou et al. (45) Date of Patent: Dec. 22, 2009 (54) METHODS FOR CONDUCTING ASSAYS FOR 5,506,121 A 4/1996 Skerra et al. ENZYME ACTIVITY ON PROTEIN 5,510,270 A 4/1996 Fodor et al. MICROARRAYS 5,512,492 A 4/1996 Herron et al. 5,516,635 A 5/1996 Ekins et al. (75) Inventors: Fang X. Zhou, New Haven, CT (US); 5,532,128 A 7/1996 Eggers Barry Schweitzer, Cheshire, CT (US) 5,538,897 A 7/1996 Yates, III et al. s s 5,541,070 A 7/1996 Kauvar (73) Assignee: Life Technologies Corporation, .. S.E. al Carlsbad, CA (US) 5,585,069 A 12/1996 Zanzucchi et al. 5,585,639 A 12/1996 Dorsel et al. (*) Notice: Subject to any disclaimer, the term of this 5,593,838 A 1/1997 Zanzucchi et al. patent is extended or adjusted under 35 5,605,662 A 2f1997 Heller et al. U.S.C. 154(b) by 0 days. 5,620,850 A 4/1997 Bamdad et al. 5,624,711 A 4/1997 Sundberg et al. (21) Appl. No.: 10/865,431 5,627,369 A 5/1997 Vestal et al. 5,629,213 A 5/1997 Kornguth et al. (22) Filed: Jun. 9, 2004 (Continued) (65) Prior Publication Data FOREIGN PATENT DOCUMENTS US 2005/O118665 A1 Jun. 2, 2005 EP 596421 10, 1993 EP 0619321 12/1994 (51) Int. Cl. EP O664452 7, 1995 CI2O 1/50 (2006.01) EP O818467 1, 1998 (52) U.S.
    [Show full text]
  • Effects of Neomycin on Absorption, Synthesis, And/Or Flux of Cholesterol in Man
    Effects of neomycin on absorption, synthesis, and/or flux of cholesterol in man. A Sedaghat, … , J R Crouse, E H Ahrens Jr J Clin Invest. 1975;55(1):12-21. https://doi.org/10.1172/JCI107902. Research Article The mode of action of the hypocholesteremic drug neomycin (2 g/day) was studied in four patients. All showed a significant reduction in plasma cholesterol concentrations (mean 25 percent, range 18-31 percent), and in one of three patients with hyperglyceridemia there was a decrease of plasma triglycerides of 26 percent. Cholesterol absorption was measured in three of four patients: there was a marked decrease. Sterol balance studies in four patients showed an unabating increase in fecal neutral steroid excretion (mean increase 345 mg/day, range 323-361) for 3-5 wk after plasma cholesterol levels had reached a new and lower plateau. Fecal acidic steroid excretion increased temporarily in two patients, with a sustained increase of 93 mg/day in only one. Daily stool weights increased significantly in three of four patients, though none had steatorrhea; there was a significant reduction in excretion of secondary bile acids; neutral sterol degradation rates were not affected by the drug. Slopes of plasma cholesterol-specific activity time curves did not change. These results fail to support the suggestion that neomycin acts as a bile acid precipitant. The finding of increased fecal neutral steroid excretion is consistent with decreased cholesterol absorption, but also with increased cholesterol absorption, but also with increased cholesterol synthesis (secondary to release of negative feedback control), with increased flux of cholesterol from tissues, or with a […] Find the latest version: https://jci.me/107902/pdf Effects of Neomycin on Absorption, Synthesis, and/or Flux of Cholesterol in Man ABBAs SEDAGHAT, PAUL SAmuEL, JoN R.
    [Show full text]
  • Enzyme-Induced Inactivation of Transaminases by Acetylenic and Vinyl Analogues of 4-Aminobutyrate by ROBERT A
    Biochem. J. (1979) 177,721-728 721 Printed in Great Britain Enzyme-Induced Inactivation of Transaminases by Acetylenic and Vinyl Analogues of 4-Aminobutyrate By ROBERT A. JOHN,* EIRIAN D. JONES* and LESLIE J. FOWLERt *Department ofBiochemistry, University College, P.O. Box 78, Cardiff CF1 1XL, Wales, U.K., and tDepartment ofPharmacology, School ofPharmacy, Brunswick Square, London WC1N lAX, U.K. (Received 25 August 1978) The reactions of two analogues of 4-aminobutyrate, namely 4-aminohex-5-ynoate and 4-aminohex-5-enoate, with three transaminases were studied. Three pure enzymes were used, aminobutyrate transaminase (EC 2.6.1.19), ornithine transaminase (EC 2.6.1.13) and aspartate transaminase (EC 2.6.1.1), and the course of the reactions was studied by observing changes in the absorption spectrum of the bound coenzyme and by observing loss of activity. All of the enzymes were inactivated by either inhibitor, but amino- hexenoate showed a marked specificity for aminobutyrate transaminase. Aminohexynoate was most potent towards ornithine transaminase, and with this enzyme transamination of the inhibitor is an important factor in protecting the enzyme. Most of the reactions could be analysed as first order, with the observed rate constant showing a hyperbolic dependence on inhibitor concentration. Ideally compounds intended to act as drugs by the resulting aminoacrylic intermediate reacts with specific inhibition of a particular metabolic step lysine-258 and cysteine-390 of the enzyme (John et should show an absolute selectivity towards the al., 1973). However, in addition there is a slow trans- target enzyme. One means of approaching this ideal amination that protects the enzyme from further in- is to prepare a compound that not only bears a activation, because the pyridoxamine form of the strong structural resemblance to the substrate, but enzyme, although fully active in the normal trans- also becomes reactive as an irreversible inhibitor only amination reaction, cannot combine productively as a result of the operation of the enzyme's normal with amino acids.
    [Show full text]
  • Overexpression of Heat Shock Protein HSP90AA1 and Translocase of The
    Clinical Biochemistry 63 (2019) 10–17 Contents lists available at ScienceDirect Clinical Biochemistry journal homepage: www.elsevier.com/locate/clinbiochem Overexpression of heat shock protein HSP90AA1 and translocase of the outer mitochondrial membrane TOM34 in HCV-induced hepatocellular T carcinoma: A pilot study ⁎ Eman A. Toraiha,b, Hani G. Alrefaic, , Mohammad H. Husseind, Ghada M. Helalc, ⁎⁎ Moataz S. Khashanae, Manal S. Fawzyf,g, a Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt b Center of Excellence of Molecular and Cellular Medicine, Suez Canal University, Ismailia, Egypt c Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt d Ministry of Health and population, Cairo, Egypt e Faculty of Medicine, Suez Canal University, Ismailia, Egypt f Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia g Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt ARTICLE INFO ABSTRACT Keywords: Objective: Identification of new molecular markers to enhance early diagnosis, prognosis and/or treatment of Hepatocellular Carcinoma hepatocellular carcinoma (HCC) is a need. TOM34 (34 kDa-translocase of the outer mitochondrial membrane) TOM34 protein expression deregulation has demonstrated to be involved in the growth of many cancers. Here, we aimed HSPA4 at evaluating serum TOM34 and some heat shock proteins (HSPA4, HSPA1B, and HSP90AA1) expressions in HSPA1B hepatitis C virus (HCV)-related cirrhosis and HCV-induced HCC relative to controls and correlating these ex- HSP90AA1 pressions to the clinicopathological data. Real-Time Polymerase Chain Reaction Methods: Serum specimens were collected from 90 patients with HCV associated complications (30 cirrhotic, 30 early HCC and 30 late HCC) and 60 controls.
    [Show full text]