OBJECTIVE: To explore the effects of oral exposure to titanium dioxide nanoparticles (TiO₂ NPs) on the composition and structure of human gut microbiota. METHODS: The particle size, shape, crystal shape and degree of agglomeration in ultrapure water of TiO₂ NPs were characterized. The in vitro human digestive tract microecological simulation system was established by simulating the fluid environment and physical conditions of stomach, small intestine and colon, and the stability of the simulation system was evaluated. The bacterial communities were extracted from human feces and cultured stably in the simulated system. They were exposed to 0, 20, 100 and 500 mg/L TiO₂ NPs, respectively, and the bacterial fluids were collected after 24 h of exposure. The effect of TiO₂ NPs on the composition and structure of human gut microbiota was analyzed by 16S rRNA sequencing technology. Linear discriminant analysis effect size (LEfSe) was used to screen differential bacteria, and the Kyoto encyclopedia of genes and genomes (KEGG) database for functional prediction. RESULTS: The spherical and anatase TiO₂ NPs were (25.12±5.64) nm in particle size, while in ultra-pure water hydrated particle size was (609.43±60.35) nm and Zeta potential was (-8.33±0.22) mV. The in vitro digestive tract microecology simulation system reached a relatively stable state after 24 hours, and the counts of Enterococci, Enterobacte-rium, and Lactobacillus reached (1.6±0.85)×10⁷, (5.6±0.82)×10⁷ and (2.7±1.32)×10⁷, respectively. 16S rRNA sequencing results showed that compared with the control group, the number and evenness of gut microbiota were not significantly affected at phylum, class, order, family and genus levels in TiO₂ NPs groups (20, 100 and 500 mg/L). The relative abundance of some species was significantly changed, and a total of 42 different bacteria were screened between the TiO₂ NPs groups (20, 100 and 500 mg/L) and the control group [linear discriminant analysis(LDA) score>3], represented by Enterobacter, Bacteroidaceae, Lactobacillaceae, Bifidobacteriaceae and Clostridium. Further predictive analysis of gut microbiota function showed that TiO₂ NPs might affect oxidative phosphorylation, energy meta-bolism, phosphonate and phosphonate metabolism, and methane metabolism (P < 0.05). CONCLUSION In human digestive tract microecological simulation system, TiO₂ NPs could significantly change the composition and structure of human gut microbiota, represented by Enterobacter and probiotics, and may further affect a variety of metabolism and function of the body.
Bacteria/genetics* ; Gastrointestinal Microbiome ; Gastrointestinal Tract ; Humans ; Nanoparticles ; Organophosphonates/pharmacology* ; RNA, Ribosomal, 16S ; Titanium/pharmacology* ; Water/pharmacology*

BACKGROUND/AIMS: To analyze the effects of preexisting lamivudine (LAM) resistance and applying antiviral treatment (adefovir [ADV] add-on LAM combination treatment) on long-term treatment outcomes, and comparing the clinical outcomes of antiviral-naïve chronic hepatitis B patients receiving entecavir (ETV) monotherapy. METHODS: This study enrolled 73 antiviral-naïve patients who received 0.5-mg ETV as an initial therapy and 54 patients who received ADV add-on LAM combination treatment as a rescue therapy from July 2006 to July 2010. RESULTS: During 24-month treatments, the decreases in serum log10HBV-DNA values (copies/mL) were significantly greater in the antiviral-naïve patients treated with ETV than the patients receiving ADV add-on LAM combination treatment. The biochemical response rates for alanine aminotransferase normalization at 6 months (ETV) and 12 months (ADV add-on LAM) were 90.4% (66/73) and 77.8% (42/54), respectively (P=0.048). A Kaplan-Meier analysis indicated that the rates of serologic response, viral breakthrough, and emergence of genotypic resistance did not differ significantly between the two patient groups. There were also no significant intergroup differences in the rates of disease progression (PD) and new development of hepatocellular carcinoma (HCC). CONCLUSION: The long-term clinical outcomes of antiviral-naïve patients treated with ETV and LAM-resistant patients receiving ADV add-on LAM combination treatment were comparable in terms of the emergence of HCC and disease progression.
Adenine/*analogs & derivatives/pharmacology/therapeutic use ; Adult ; Alanine Transaminase/blood ; Antibodies, Viral/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Disease Progression ; Drug Resistance, Viral/drug effects ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Genotype ; Guanine/analogs & derivatives/pharmacology/therapeutic use ; Hepatitis B e Antigens/blood ; Hepatitis B virus/drug effects/genetics/isolation & purification ; Hepatitis B, Chronic/*drug therapy ; Humans ; Lamivudine/pharmacology/therapeutic use ; Male ; Middle Aged ; Organophosphonates/pharmacology/*therapeutic use ; Treatment Outcome

According to the super-position principle of the reinforcement of biological activities, a series of novel E-substituted 2, 3-diaryl propenoic acyloxy phosphonate derivatives were designed and synthesized. And the structures of the target compounds were confirmed by IR, 1H NMR, 13C NMR and elemental analysis. Furthermore, the cytotoxicities of all compounds on A-549, SGC-7901 and EC-109 in vitro were evaluated by MTT assay, and some of them showed good antitumor activity. Among the active compounds, especially, the IC50 value of compound 3e was (12.7 ± 1.9) μmol x L(-1) against A-549 cells, similar to cisplatin [IC50 = (8.0 ± 1.5) μmol x L(-1)], compounds 3g and 3k had better inhibition effect on EC-109 cells growth, with the IC50 values of (9.5 ± 1.8) μmol x L(-1) and (11.5 ± 0.9) μmol x L(-1) respectively, and compounds 3i and 3k exhibited good cytotoxic property on A-549, SGC-7901 and EC-109, which were worth further investigation.
Antineoplastic Agents ; chemical synthesis ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; Drug Design ; Humans ; Organophosphonates ; chemical synthesis ; pharmacology

Although much advancement has been achieved in the treatment of chronic hepatitis B, antiviral resistance is still a challenging issue. Previous generation antiviral agents have already developed resistance in a number of patients, and it is still being used especially in resource limited countries. Once antiviral resistance occurs, it predisposes to subsequent resistance, resulting in multidrug resistance. Therefore, prevention of initial antiviral resistance is the most important strategy, and appropriate choice and modification of therapy would be the cornerstone in avoiding treatment failures. Until now, management of antiviral resistance has been evolving from sequential therapy to combination therapy. In the era of tenofovir, the paradigm shifts again, and we have to decide when to switch and when to combine on the basis of newly emerging clinical data. We expect future eradication of chronic hepatitis B virus infection by proper prevention and optimal management of antiviral resistance.
Adenine/analogs & derivatives/pharmacology/therapeutic use ; Antiviral Agents/pharmacology/*therapeutic use ; Drug Resistance, Viral/drug effects ; Drug Therapy, Combination ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/*drug therapy/prevention & control ; Humans ; Mutation ; Nucleosides/*chemistry/pharmacology/therapeutic use ; Organophosphonates/pharmacology/therapeutic use ; Virus Replication/drug effects

OBJECTIVETo analyze the prognosis of hepatitis B virus (HBV) recurrence after liver transplantation.

METHODSThirty-eight patients (37 males; 1 female) with HBV-related end-stage liver disease underwent liver transplantation at our institute between December 1998 and November 2009 and experienced HBV recurrence. Clinical data from pre-transplant and follow-up examinations were retrospectively retrieved from medical records, and included serologic indices of HBV (HBV DNA, markers of liver function) and histological findings from liver biopsy.

RESULTSThe median follow-up time was 45.1 months. The median time to HBV recurrence after transplantation was 31.8 months (range: 0.3 to 72.8 months) for histologically benign cases and 13.7 months (range: 0.3 to 66.6 months) for malignant cases. HBV DNA gene mutations were detected in 21% (8/38) of cases. Eighteen patients were treated with entecavir or adefovir, with respect to gene mutations, and HBV DNA fell below 103 copies/ml and liver function became normal. Twenty-two patients died, and causes of death included hepatocellular carcinoma (HCC, n=18), organ failure (n=2), or infection (n=1).

CONCLUSIONHBV gene mutations and HCC recurrence were important risk factors for HBV recurrence in our study population. In addition, patients with benign liver diseases who received salvage therapy with adefovir or entecavir achieved a satisfactory prognosis.

Adenine ; analogs & derivatives ; pharmacology ; Adult ; Female ; Hepatitis B ; diagnosis ; virology ; Hepatitis B virus ; drug effects ; genetics ; Humans ; Lamivudine ; pharmacology ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Organophosphonates ; pharmacology ; Prognosis ; Recurrence ; Retrospective Studies

Adefovir dipivoxil (ADV) is a nucleotide anti-hepatitis B virus drug, which is able to effectively repress the replication of hepatitis B virus (HBV). ADV is a reverse transcriptase inhibitor. However, with the prolonged period of using, many kinds of HBV genetic mutants will occur and therefore resistance to ADV will be created. The purpose of this review is to draw the attention to the molecular mechanism of resistance to ADV.
Adenine ; analogs & derivatives ; pharmacology ; Animals ; Antiviral Agents ; pharmacology ; Drug Resistance ; genetics ; Hepatitis B virus ; drug effects ; genetics ; Humans ; Mutation ; Organophosphonates ; pharmacology ; Reverse Transcriptase Inhibitors ; pharmacology

This study was aimed to research the changes of the biological characteristics of Hepatitis B virus-resistant mutant model in vivo. The anti-ADV mutant HBV plasmid of rtA181V and rtN236T, prepared by Multi Site-Directed Mutagenesis Kit, was transferred into mice via the tail vein, and the levels of HBV-DNA replication were detected after Anti-HBV drugs treatment. The HBV-DNA replication had been detected in the mutant mice, which means that the establishment of HBV-resistance mutant model in vivo was successful, but the level of HBV DNA replication intermediates in the anti-ADV mutant mice liver were decreased compared with wild 4.1kb HBV plasmid mice. The wild-type mice were sensitive to Lamivudine, Adefovir dipivoxil and Entecavir. Though the mutant mice were also sensitive to Entecavir, the sensitivity to lamivudine and Adefovir dipivoxil decreased. As a result, this study established the Adefovir-resistant hepatitis B virus mouse model successfully. However, the replication level of HBV-DNA was reduced in this model, and Adefovir dipivoxil in the mutant mice had no significant inhibition effect on HBV-DNA.
Adenine ; analogs & derivatives ; pharmacology ; Animals ; Antiviral Agents ; pharmacology ; Base Sequence ; Drug Resistance, Viral ; genetics ; Hepatitis B ; drug therapy ; virology ; Hepatitis B virus ; drug effects ; genetics ; Male ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Mutagenesis, Site-Directed ; Mutation ; Organophosphonates ; pharmacology

Adenine ; analogs & derivatives ; pharmacology ; therapeutic use ; Adult ; Drug Resistance, Viral ; Female ; Genes, Viral ; Genotype ; Hepatitis B virus ; drug effects ; genetics ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Organophosphonates ; pharmacology ; therapeutic use

OBJECTIVETo study the factors influencing the long-term usage of lamivudine (LAM) in chronic hepatitis B (CHB) patients and the management after drug-resistance.

METHODS383 cases of naive CHB patients in our outpatient clinic were treated with lamivudine (100 mg/d) and followed up for at least over 1 year from 2001 to 2010. 129 cases encountered lamivudine-resistance and were then divided into two groups: patients in group A were switched to adefovir dipivoxil (ADV) alternative treatment and those patients in group B were added with ADV for continuous treatment. Efficacy assessment factors included serum HBV markers, HBV DNA, ALT, AFP and other biochemical indicators.

RESULTSAmong the 383 cases, patients with HBV DNA negative conversion (PCR below test line) at 3 months, 6 months, 1 year, 2 years, 3 years and > 3 years after initial treatment were respectively 156 cases (40.7%), 213 cases (55.6%), 228 cases (59.5% ), 217cases (56.7%), 214 cases (55.9%) and 213 cases (55.6%). HBeAg/HBeAb seroconversion occurred in 62 cases (22.6%). 12 cases were found with primary LAM resistance, 129 cases with HBV breakthrough and rebound, the cumulative resistance rate was 36.8% and the cumulative rebound rate was 34.8%. High baseline viral load, baseline ALT levels < 2 ULN, Lower virologic response rate at week 24 were associated with a higher rebound rate (chi2 is 35.716, 8.728, 43.534, respectively, all with P < 0.01).Viral breakthrough and rebound occurred in 112 patients (86.8%) within 1 year and a half, 123 patients (95.3%) occurred at the end of 2 years and no patient with viral breakthrough and rebound after 5 years. For the patients with viral rebound in group A and group B, the rates of HBV DNA loss were 22.7% (15/66) and 58.7% (37/63) respectively, and the viral response rates were 59.1% (39/66) and 87.3% (52/63) respectively, with chi2 values equaled 17.364 and 12.975 respectively (P < 0.01).

CONCLUSIONFor the chronic hepatitis B patients on initial treatment with lamivudine, the viral rebound occurred mainly within 2 years. LAM combined with ADV is more effective than ADV alone for lamivudine-resistant patients.

Adenine ; analogs & derivatives ; pharmacology ; therapeutic use ; Adolescent ; Adult ; Aged ; Antiviral Agents ; pharmacology ; therapeutic use ; Drug Resistance, Viral ; Female ; Follow-Up Studies ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Organophosphonates ; pharmacology ; therapeutic use ; Young Adult

OBJECTIVETo observe the effect of Shugan Jianpi Bushen Recipe (SJBR) on the splenic T lymphocytes and virus load in the hepatitis B virus (HBV) transgenic (Tg) mice, and to study its antiviral efficacy and mechanisms of action.

METHODSSixty male BALB/C mice of SPF grade were included. Ten non-HBV Tg male mice were included as the normal control group. Fifty HBV Tg mice were randomly divided into five groups, i. e., the model group, the adefovir (ADV) group, the low dose SJBR group, the middle dose SJBR group, and the high dose SJBR group, ten in each. 10, 20, and 40 g/kg SJBR crude drug was respectively given by gastro-gavage to mice in the low dose SJBR group, the middle dose SJBR group, and the high dose SJBR group. ADV 50 mg/kg body weight was given by gastrogavage to mice in the ADV group. Equal volume of sterilized iso-osmia was given to mice in the normal group and the model group. The medication was performed once daily, totally for 21 successive days. The serum HBV DNA titers of HBV Tg mice were detected using Real-time fluorescent PCR one day before administration (T0), ten days after administration (T1), 21 days after administration (T2), and three days after withdrawal (T3), respectively; the serum hepatitis B surface antigen (HBsAg) of HBV Tg mice on T3 was detected by ELISA. The splenic T lymphocyte percent of all mice was detected by flow cytometry.

RESULTSSerum HBsAg at TO was positive in the high-, middle-, low-dose SJBR, and ADV groups. The HBsAg negative rate at T3 was lower in the high dose SJBR group than in the ADV group, showing statistical difference (P<0.01). Compared with TO of the same group, the serum HBV DNA titers could be continually decreased by high dose SJBR, showing statistical difference (P<0.01). The serum HBV DNA titers also gradually decreased in the ADV group (P<0.01), but it somewhat increased at T3. The CD3+ cell percent could be elevated by high-, middle-, low-dose SJBR, and ADV groups (P<0.05, P<0.01). The CD8+ T cell percent could also be obviously lowered by high-, middle-, and low-dose SJBR (P<0.01). Compared with the middle-, low-dose SJBR, and ADV groups, the CD4+ T cell percent and CD4+/CD8+ increased as well as CD8+ decreased in the high dose SJBR group, showing statistical difference (P<0.01). The CD3+ T cell percent was significantly positively correlated to the decrement of HBV DNA titers between the pre-treatment and post-treatment in the middle dose SJBR group (r=0.654, P<0.05). The percents of CD4+, CD8+ T cells and CD4+/CD8+ were significantly positively correlated to the decrement of HBV DNA titers between the pre-treatment and post-treatment in the high dose SJBR group (r=0.53, r=0.79, r =0.80, P<0.01).

CONCLUSIONSSJBR were capable of inhibiting the HBV DNA duplication of HBV Tg mice. One of its anti-HBV mechanisms possibly be improving the the abnormality of T lymphocyte subsets and the immune function.

Adenine ; analogs & derivatives ; pharmacology ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Hepatitis B virus ; drug effects ; genetics ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Transgenic ; Organophosphonates ; pharmacology ; Spleen ; cytology ; virology ; T-Lymphocyte Subsets ; drug effects ; Viral Load ; drug effects ; Virus Replication ; drug effects