1.Mechanism of Zhenwu Decoction in improving renal inflammatory injury in mice with DN of spleen-kidney Yang deficiency syndrome by regulating ROCK/IKK/NF-κB pathway.
Yu-Qiu JIN ; Guang-Shun CHEN ; Min BAI ; Zhe ZHAO ; Yan-Xu CHEN ; Meng-Yuan TIAN ; Jia-Lian CHEN ; Qing-Sheng WANG ; Zhen-Hua LIU
China Journal of Chinese Materia Medica 2023;48(18):5041-5048
		                        		
		                        			
		                        			To investigate the intervention effect and mechanism of Zhenwu Decoction on diabetic nephropathy(DN) mice of spleen-kidney Yang deficiency syndrome based on the Rho-associated coiled-coil kinase(ROCK)/IκB kinase(IKK)/nuclear factor-κB(NF-κB) pathway. Ninety-five 7-week-old db/db male mice and 25 7-week-old db/m male mice were fed adaptively for one week. The DN model of spleen-kidney Yang deficiency syndrome was induced by Dahuang Decoction combined with hydrocortisone by gavage, and then the model was evaluated. After modeling, they were randomly divided into a model group, high-dose, medium-dose, and low-dose Zhenwu Decoction groups(33.8, 16.9, and 8.45 g·kg~(-1)·d~(-1)), and an irbesartan group(25 mg·kg~(-1)·d~(-1)), with at least 15 animals in each group. The intervention lasted for eight weeks. After the intervention, body weight and food intake were measured. Serum crea-tinine(Scr), blood urea nitrogen(BUN), fasting blood glucose(FBG), urinary albumin(uALb), and urine creatinine(Ucr) were determined. The uALb/Ucr ratio(ACR) and 24 h urinary protein(UTP) were calculated. Renal pathological morphology was evaluated by HE staining and Masson staining. The levels of key molecular proteins in the ROCK/IKK/NF-κB pathway were detected by Western blot. Enzyme-linked immunosorbent assay(ELISA) was used to detect interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10), and tumor necrosis factor-α(TNF-α). Compared with the blank group, the model group showed increased content of BUN, uALb, and SCr, increased values of 24 h UTP and ACR, decreased content of Ucr(P<0.05), enlarged glomeruli, thickened basement membrane, mesangial matrix proliferation, inflammatory cell infiltration, and collagen fiber deposition. The protein expression of ROCK1, ROCK2, IKK, NF-κB, phosphorylated IKK(p-IKK), phosphorylated NF-κB(p-NF-κB), and phosphorylated inhibitor of NF-κB(p-IκB) increased(P<0.05), while the protein expression of inhibitor of NF-κB(IκB) decreased(P<0.05). The levels of inflammatory factors IL-1β, IL-6, IL-8, and TNF-α increased(P<0.05), while the level of IL-10 decreased(P<0.05). Compared with the model group, the groups with drug treatment showed decreased levels of BUN, uALb, SCr, 24 h UTP, and ACR, increased level of Ucr(P<0.05), and improved renal pathological status to varying degrees. The high-and medium-dose Zhenwu Decoction groups and the irbesartan group showed reduced protein expression of ROCK1, ROCK2, IKK, NF-κB, p-IKK, p-NF-κB, and p-IκB in the kidneys(P<0.05), increased protein expression of IκB(P<0.05), decreased levels of serum inflammatory factors IL-1β, IL-6, IL-8, and TNF-α(P<0.05), and increased level of IL-10(P<0.05). Zhenwu Decoction can significantly improve renal function and renal pathological damage in DN mice of spleen-kidney Yang deficiency syndrome, and its specific mechanism may be related to the inhibition of inflammatory response by down-regulating the expression of key molecules in the ROCK/IKK/NF-κB pathway in the kidney.
		                        		
		                        		
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			NF-kappa B/metabolism*
		                        			;
		                        		
		                        			Interleukin-8
		                        			;
		                        		
		                        			Interleukin-10
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha/metabolism*
		                        			;
		                        		
		                        			Interleukin-6
		                        			;
		                        		
		                        			I-kappa B Kinase
		                        			;
		                        		
		                        			Spleen
		                        			;
		                        		
		                        			Irbesartan
		                        			;
		                        		
		                        			Uridine Triphosphate
		                        			;
		                        		
		                        			Yang Deficiency/drug therapy*
		                        			;
		                        		
		                        			Kidney/pathology*
		                        			
		                        		
		                        	
2.Effect of multi-glycosides of Tripterygium wilfordii on renal injury in diabetic kidney disease rats through NLRP3/caspase-1/GSDMD pyroptosis pathway.
Chun-Dong SONG ; Dan SONG ; Ping-Ping JIA ; Feng-Yang DUAN ; Ying DING ; Xian-Qing REN ; Wen-Sheng ZHAI ; Yao-Xian WANG ; Shu-Li HUANG
China Journal of Chinese Materia Medica 2023;48(10):2639-2645
		                        		
		                        			
		                        			This study investigated the effect of multi-glycosides of Tripterygium wilfordii(GTW) on renal injury in diabetic kidney disease(DKD) rats through Nod-like receptor protein 3(NLRP3)/cysteine-aspartic acid protease-1(caspase-1)/gsdermin D(GSDMD) pyroptosis pathway and the mechanism. To be specific, a total of 40 male SD rats were randomized into the normal group(n=8) and modeling group(n=34). In the modeling group, a high-sugar and high-fat diet and one-time intraperitoneal injection of streptozotocin(STZ) were used to induce DKD in rats. After successful modeling, they were randomly classified into model group, valsartan(Diovan) group, and GTW group. Normal group and model group were given normal saline, and the valsartan group and GTW group received(ig) valsartan and GTW, respectively, for 6 weeks. Blood urea nitrogen(BUN), serum creatinine(Scr), alanine ami-notransferase(ALT), albumin(ALB), and 24 hours urinary total protein(24 h-UTP) were determined by biochemical tests. The pathological changes of renal tissue were observed based on hematoxylin and eosin(HE) staining. Serum levels of interleukin-1β(IL-1β) and interleukin-18(IL-18) were detected by enzyme-linked immunosorbent assay(ELISA). Western blot was used to detect the expression of pyroptosis pathway-related proteins in renal tissue, and RT-PCR to determine the expression of pyroptosis pathway-related genes in renal tissue. Compared with the normal group, the model group showed high levels of BUN, Scr, ALT, and 24 h-UTP and serum levels of IL-1β and IL-18(P<0.01), low level of ALB(P<0.01), severe pathological damage to kidney, and high protein and mRNA levels of NLRP3, caspase-1, and GSDMD in renal tissue(P<0.01). Compared with the model group, valsartan group and GTW group had low levels of BUN, Scr, ALT, and 24 h-UTP and serum levels of IL-1β and IL-18(P<0.01), high level of ALB(P<0.01), alleviation of the pathological damage to the kidney, and low protein and mRNA levels of NLRP3, caspase-1, and GSDMD in renal tissue(P<0.01 or P<0.05). GTW may inhibit pyroptosis by decreasing the expression of NLRP3/caspase-1/GSDMD in renal tissue, thereby relieving the inflammatory response of DKD rats and the pathological injury of kidney.
		                        		
		                        		
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Diabetic Nephropathies/genetics*
		                        			;
		                        		
		                        			Interleukin-18/metabolism*
		                        			;
		                        		
		                        			Glycosides/pharmacology*
		                        			;
		                        		
		                        			Tripterygium
		                        			;
		                        		
		                        			NLR Family, Pyrin Domain-Containing 3 Protein/metabolism*
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Caspase 1/metabolism*
		                        			;
		                        		
		                        			Pyroptosis
		                        			;
		                        		
		                        			Uridine Triphosphate/pharmacology*
		                        			;
		                        		
		                        			Kidney
		                        			;
		                        		
		                        			Valsartan/pharmacology*
		                        			;
		                        		
		                        			RNA, Messenger/metabolism*
		                        			;
		                        		
		                        			Diabetes Mellitus
		                        			
		                        		
		                        	
3.Gene clone and functional identification of sterol glycosyltransferases from Paris polyphylla var. yunnanensis.
Min HE ; Si-Yuan GUO ; Yan YIN ; Chi ZHANG ; Xia-Nan ZHANG
China Journal of Chinese Materia Medica 2023;48(14):3774-3785
		                        		
		                        			
		                        			In this study, the authors cloned a glycosyltransferase gene PpUGT2 from Paris polyphylla var. yunnanensis with the ORF length of 1 773 bp and encoding 590 amino acids. The phylogenetic tree revealed that PpUGT2 belonged to the UGT80A subfamily and was named as UGT80A49 by the UDP-glycosyltransferase(UGT) Nomenclature Committee. The expression vector pET28a-PpUGT2 was constructed, and enzyme catalytic reaction in vitro was conducted via inducing protein expression and extraction. With UDP-glucose as sugar donor and diosgenin and pennogenin as substrates, the protein was found with the ability to catalyze the C-3 hydroxyl β-glycosylation of diosgenin and pennogenin. To further explore its catalytic characteristic, 15 substrates including steroids and triterpenes were selected and PpUGT2 showed its activity towards the C-17 position of sterol testosterone with UDP-glucose as sugar donor. Homology modelling and molecule docking of PpUGT2 with substrates predicted the key residues interacting with ligands. The re-levant residues of PpUGT2-ligand binding model were scanned to calculate the corresponding mutants, and the optimized mutants were obtained according to the changes in binding affinity of the ligand with protein and the surrounding residues within 5.0 Å of ligands, which had reference value for design of the mutants. This study laid a foundation for further exploring the biosynthetic pathway of polyphyllin as well as the structure of sterol glycosyltransferases.
		                        		
		                        		
		                        		
		                        			Ligands
		                        			;
		                        		
		                        			Glycosyltransferases/genetics*
		                        			;
		                        		
		                        			Sterols
		                        			;
		                        		
		                        			Phylogeny
		                        			;
		                        		
		                        			Ascomycota
		                        			;
		                        		
		                        			Liliaceae/chemistry*
		                        			;
		                        		
		                        			Melanthiaceae
		                        			;
		                        		
		                        			Diosgenin
		                        			;
		                        		
		                        			Sugars
		                        			;
		                        		
		                        			Glucose
		                        			;
		                        		
		                        			Uridine Diphosphate
		                        			
		                        		
		                        	
4.Oxidative phosphorylation safeguards pluripotency via UDP-N-acetylglucosamine.
Jiani CAO ; Meng LI ; Kun LIU ; Xingxing SHI ; Ning SUI ; Yuchen YAO ; Xiaojing WANG ; Shiyu LI ; Yuchang TIAN ; Shaojing TAN ; Qian ZHAO ; Liang WANG ; Xiahua CHAI ; Lin ZHANG ; Chong LIU ; Xing LI ; Zhijie CHANG ; Dong LI ; Tongbiao ZHAO
Protein & Cell 2023;14(5):376-381
5.Preparation and in vitro evaluation of fused deposition modeling 3D printed compound tablets of captopril and hydrochlorothiazide.
Zhi Sheng LI ; Hao Nan QIAN ; Tian Yuan FAN
Journal of Peking University(Health Sciences) 2022;54(3):572-577
		                        		
		                        			OBJECTIVE:
		                        			To explore the feasibility of preparing compound tablets for the treatment of hypertension by fused deposition modeling (FDM) 3D printing technology and to evaluate the quality of the printed compound tablets in vitro.
		                        		
		                        			METHODS:
		                        			Polyvinyl alcohol (PVA) filaments were used as the exci-pient to prepare the shell of tablet. The ellipse-shaped tablets (the length of major axes of ellipse was 20 mm, the length of the minor axes of ellipse was 10 mm, the height of tablet was 5 mm) with two separate compartments were designed and printed using FDM 3D printer. The height of layer was 0.2 mm, and the thickness of roof or floor was 0.6 mm. The thickness of shell was 1.2 mm, and the thickness of the partition wall between the two compartments was 0.6 mm. Two cardiovascular drugs, captopril (CTP) and hydrochlorothiazide (HCT), were selected as model drugs for the printed compound tablet and filled in the two compartments of the tablet, respectively. The microscopic morphology of the tablets was observed by scanning electron microscopy (SEM). The weight variation of the tablets was investigated by electronic scale. The hardness of the tablets was measured by a single-column mechanical test system. The contents of the drugs in the tablets were determined by high performance liquid chromatography (HPLC), and the dissolution apparatus was used to measure the in vitro drug release of the tablets.
		                        		
		                        			RESULTS:
		                        			The prepared FDM 3D printed compound tablets were all in good shape without printing defects. The average weight of the tablets was (644.3±6.55) mg. The content of CTP and HCT was separately (52.3±0.26) mg and (49.6±0.74) mg. A delayed in vitro release profile was observed for CTP and HCT, and the delayed release time for CTP and HCT in vitro was 20 min and 40 min, respectively. The time for 70% of CTP and HCT released was separately 30 min and 60 min.
		                        		
		                        			CONCLUSION
		                        			CTP and HCT compound tablets were successfully prepared by FDM 3D printing technology, and the printed tablets were of good qualities.
		                        		
		                        		
		                        		
		                        			Captopril
		                        			;
		                        		
		                        			Cytidine Triphosphate
		                        			;
		                        		
		                        			Drug Liberation
		                        			;
		                        		
		                        			Hydrochlorothiazide
		                        			;
		                        		
		                        			Printing, Three-Dimensional
		                        			;
		                        		
		                        			Tablets/chemistry*
		                        			;
		                        		
		                        			Technology, Pharmaceutical/methods*
		                        			
		                        		
		                        	
6.A real-world study of the efficacy and safety of sofosbuvir and velpatasvir in the treatment of HCV-infected patients in a county in northern China.
Li Xia QIU ; Hai Bin YU ; Wei LIN ; Yi Rong LIU ; Yun Dong QIU ; Zhong Jie HU ; Xing Huo PANG ; Jing ZHANG ; Ya Li LIU
Chinese Journal of Hepatology 2022;30(4):395-401
		                        		
		                        			
		                        			Objective: To evaluate the real-world efficacy and safety of sofosbuvir and velpatasvir (SOF/VEL) tablets in the treatment of Chinese patients with chronic HCV infection. Methods: An open-label, single-center, prospective clinical study was conducted in a county in northern China. A total of 299 cases were enrolled. Of these, 161 cases with chronic hepatitis C and 73 cases with compensated cirrhosis received SOF/VEL for 12 weeks. 65 cases with decompensated cirrhosis received SOF/VEL combined with ribavirin for 12 weeks (22 cases) or SOF/VEL for 24 weeks (43 cases). Virological indicators, liver and renal function indexes, and liver stiffness measurement were detected at baseline, the fourth week of treatment, the end of treatment, and the 12-weeks of follow-up. Adverse reactions and laboratory abnormalities were observed during the course of treatment . The primary endpoint was undetectable rate of HCV RNA (SVR12) at 12 weeks of follow-up with the use of modified intention-to-treat (mITT) approach. Measurement data between two groups were compared using t-test. One Way ANOVA was used for comparison between multiple groups. Enumeration data were analyzed by chi-square test or Fisher's exact test. Results: 291 cases had completed treatment. HCV RNA was undetectable after 12 weeks of follow-up, and the SVR12 rate was 97.3% (95% confidence interval: 95.4%-99.3%). Among them, 97.4% of genotype 1b, 96.4% of genotype 2a, and 100% of those with undetected genotype achieved SVR12. The SVR12 rates in patients with chronic hepatitis C, compensated and decompensated liver cirrhosis were 98.1%, 98.6% and 93.8%, respectively. An improvement in alanine aminotransferase, aspartate aminotransferase and other liver biochemical indicators accompanied with virological clearance and reduced liver stiffness measurement was observed in patients with compensated cirrhosis, with statistically significant difference. There was no significant abnormality in renal function before and after treatment. The most common adverse reactions were fatigue, headache, epigastric discomfort and mild diarrhea. The overall adverse reactions were mild. One patient died of decompensated liver cirrhosis combined with massive upper gastrointestinal bleeding, which was unrelated to antiviral treatment. Four patients discontinued treatment prematurely due to adverse events. Relapse was occurred in four cases, and drug-resistance related mutations were detected in three cases. Conclusion: Sofosbuvir and velpatasvir tablets in Chinese HCV-infected patients with different genotypes, different clinical stages or previously treated with pegylated interferon combined with ribavirin resulted in higher SVR12, indicating that the treatment safety profile is good.
		                        		
		                        		
		                        		
		                        			Antiviral Agents/therapeutic use*
		                        			;
		                        		
		                        			Carbamates
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Hepacivirus/genetics*
		                        			;
		                        		
		                        			Hepatitis C/drug therapy*
		                        			;
		                        		
		                        			Hepatitis C, Chronic/drug therapy*
		                        			;
		                        		
		                        			Heterocyclic Compounds, 4 or More Rings
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Liver Cirrhosis/complications*
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			RNA
		                        			;
		                        		
		                        			Ribavirin/therapeutic use*
		                        			;
		                        		
		                        			Sofosbuvir/adverse effects*
		                        			;
		                        		
		                        			Sustained Virologic Response
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
7.Construction of cell factories for high production of ginsenoside Rh_2 in Saccharomyces cerevisiae.
Yu-Song SHI ; Dong WANG ; Rong-Sheng LI ; Xue-Li ZHANG ; Zhu-Bo DAI
China Journal of Chinese Materia Medica 2022;47(3):651-658
		                        		
		                        			
		                        			Ginsenoside Rh_2 is a rare active ingredient in precious Chinese medicinal materials such as Ginseng Radix et Rhizoma, Notoginseng Radix et Rhizoma, and Panacis Quinquefolii Radix. It has important pharmacological activities such as anti-cancer and improving human immunity. However, due to the extremely low content of ginsenoside Rh_2 in the source plants, the traditional way of obtaining it has limitations. This study intended to apply synthetic biological technology to develop a cell factory of Saccharomyces cerevisiae to produce Rh_2 by low-cost fermentation. First, we used the high protopanaxadiol(PPD)-yielding strain LPTA as the chassis strain, and inserted the Panax notoginseng enzyme gene Pn1-31, together with yeast UDP-glucose supply module genes[phosphoglucose mutase 1(PGM1), α-phosphoglucose mutase(PGM2), and uridine diphosphate glucose pyrophosphorylase(UGP1)], into the EGH1 locus of yeast chromosome. The engineered strain LPTA-RH2 produced 17.10 mg·g~(-1) ginsenoside Rh_2. This strain had low yield of Rh_2 while accumulated much precursor PPD, which severely restricted the application of this strain. In order to further improve the production of ginsenoside Rh_2, we strengthened the UDP glucose supply module and ginsenoside Rh_2 synthesis module by engineered strain LPTA-RH2-T. The shaking flask yield of ginsenoside Rh_2 was increased to 36.26 mg·g~(-1), which accounted for 3.63% of the dry weight of yeast cells. Compared with those of the original strain LPTA-RH2, the final production and the conversion efficiency of Rh_2 increased by 112.11% and 65.14%, respectively. This study provides an important basis for further obtaining the industrial-grade cell factory for the production of ginsenoside Rh_2.
		                        		
		                        		
		                        		
		                        			Fermentation
		                        			;
		                        		
		                        			Ginsenosides
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Panax/genetics*
		                        			;
		                        		
		                        			Panax notoginseng
		                        			;
		                        		
		                        			Saccharomyces cerevisiae/genetics*
		                        			;
		                        		
		                        			Uridine Diphosphate Glucose
		                        			
		                        		
		                        	
8.Myocardial Coverage and Radiation Dose in Dynamic Myocardial Perfusion Imaging Using Third-Generation Dual-Source CT
Masafumi TAKAFUJI ; Kakuya KITAGAWA ; Masaki ISHIDA ; Yoshitaka GOTO ; Satoshi NAKAMURA ; Naoki NAGASAWA ; Hajime SAKUMA
Korean Journal of Radiology 2020;21(1):58-67
		                        		
		                        			
		                        			n = 54) or 3rd-DSCT at 70 kV (n = 53). Image quality, estimated MBF, radiation dose, and coverage of left ventricular (LV) myocardium were compared.RESULTS: No significant differences were observed between 3rd-DSCT and 2nd-DSCT in contrast-to-noise ratio (37.4 ± 11.4 vs. 35.5 ± 11.2, p = 0.396). Effective radiation dose was lower with 3rd-DSCT (3.97 ± 0.92 mSv with a conversion factor of 0.017 mSv/mGy·cm) compared to 2nd-DSCT (5.49 ± 1.36 mSv, p < 0.001). Incomplete coverage was more frequent with 2nd-DSCT than with 3rd-DSCT (1.9% [1/53] vs. 56% [30/54], p < 0.001). In propensity score-matched cohorts, MBF was comparable between 3rd-DSCT and 2nd-DSCT in non-ischemic (146.2 ± 26.5 vs. 157.5 ± 34.9 mL/min/100 g, p = 0.137) as well as ischemic myocardium (92.7 ± 21.1 vs. 90.9 ± 29.7 mL/min/100 g, p = 0.876).CONCLUSION: The radiation increase inherent to the widened z-axis coverage in 3rd-DSCT can be balanced by using a tube voltage of 70 kV without compromising image quality or MBF quantification. In dynamic CTP, a z-axis coverage of 10.5 cm is sufficient to achieve complete coverage of the LV myocardium in most patients.]]>
		                        		
		                        		
		                        		
		                        			Cardiac Imaging Techniques
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Cytidine Triphosphate
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Image Enhancement
		                        			;
		                        		
		                        			Multidetector Computed Tomography
		                        			;
		                        		
		                        			Myocardial Perfusion Imaging
		                        			;
		                        		
		                        			Myocardium
		                        			;
		                        		
		                        			Perfusion Imaging
		                        			;
		                        		
		                        			Radiation Dosage
		                        			;
		                        		
		                        			Radiation Exposure
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
9.Concomitant use of immobilized uridine-cytidine kinase and polyphosphate kinase for 5'-cytidine monophosphate production.
Sijia WU ; Jie LI ; Chenlong HU ; Junyu TIAN ; Tong ZHANG ; Ning CHEN ; Xiaoguang FAN
Chinese Journal of Biotechnology 2020;36(5):1002-1011
		                        		
		                        			
		                        			Uridine-cytidine kinase, an important catalyst in the compensation pathway of nucleotide metabolism, can catalyze the phosphorylation reaction of cytidine to 5'-cytidine monophosphate (CMP), but the reaction needs NTP as the phosphate donor. To increase the production efficiency of CMP, uridine-cytidine kinase gene from Thermus thermophilus HB8 and polyphosphate kinase gene from Rhodobacter sphaeroides were cloned and expressed in Escherichia coli BL21(DE3). Uridine-cytidine kinase was used for the generation of CMP from cytidine and ATP, and polyphosphate kinase was used for the regeneration of ATP. Then, the D403 metal chelate resin was used to adsorb Ni²⁺ to form an immobilized carrier, and the immobilized carrier was specifically combined with the recombinant enzymes to form the immobilized enzymes. Finally, single-factor optimization experiment was carried out to determine the reaction conditions of the immobilized enzyme. At 30 °C and pH 8.0, 60 mmol/L cytidine and 0.5 mmol/L ATP were used as substrates to achieve 5 batches of high-efficiency continuous catalytic reaction, and the average molar yield of CMP reached 91.2%. The above method has the advantages of low reaction cost, high product yield and high enzyme utilization rate, and has good applied value for industrial production.
		                        		
		                        		
		                        		
		                        			Cytidine Monophosphate
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Escherichia coli
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			Industrial Microbiology
		                        			;
		                        		
		                        			methods
		                        			;
		                        		
		                        			Phosphotransferases (Phosphate Group Acceptor)
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Uridine Kinase
		                        			
		                        		
		                        	
10.Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
Shinya SATO ; Kei MORIYA ; Masanori FURUKAWA ; Soichiro SAIKAWA ; Tadashi NAMISAKI ; Mitsuteru KITADE ; Hideto KAWARATANI ; Kosuke KAJI ; Hiroaki TAKAYA ; Naotaka SHIMOZATO ; Yasuhiko SAWADA ; Kenichiro SEKI ; Koh KITAGAWA ; Takemi AKAHANE ; Akira MITORO ; Yasushi OKURA ; Junichi YAMAO ; Hitoshi YOSHIJI
Clinical and Molecular Hepatology 2019;25(1):65-73
		                        		
		                        			
		                        			BACKGROUND/AIMS: L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation against hemolytic anemia during antiviral treatment using ribavirin in patients with hepatitis C virus (HCV)-related chronic liver disease. METHODS: A total of 41 patients with chronic hepatitis were consecutively enrolled in this study. Group A (n=22) received sofosbuvir plus ribavirin for 3 months, whereas group B (n=19) was treated with sofosbuvir, ribavirin, and L-carnitine. Hemoglobin concentration changes, the effects of antiviral treatment, and the health status of patients were analyzed using short form-8 questionnaires. RESULTS: A significantly smaller decrease in hemoglobin concentration was observed in group B compared to group A at every time point. Moreover, the prescribed dose intensity of ribavirin in group B was higher than that of group A, resulting in a higher ratio of sustained virological response (SVR) 24 in group B compared with group A. The physical function of patients in group B was also significantly improved compared to group A at the end of antiviral treatment. CONCLUSIONS: L-carnitine supplementation alleviates ribavirin-induced hemolytic anemia in patients with HCV and helps relieve the physical burden of treatment with ribavirin-containing regimens. These advantages significantly increase the likelihood of achieving SVR.
		                        		
		                        		
		                        		
		                        			Anemia
		                        			;
		                        		
		                        			Anemia, Hemolytic
		                        			;
		                        		
		                        			Carnitine
		                        			;
		                        		
		                        			Drug Therapy
		                        			;
		                        		
		                        			Hepacivirus
		                        			;
		                        		
		                        			Hepatitis C
		                        			;
		                        		
		                        			Hepatitis C, Chronic
		                        			;
		                        		
		                        			Hepatitis
		                        			;
		                        		
		                        			Hepatitis, Chronic
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hyperammonemia
		                        			;
		                        		
		                        			Liver Cirrhosis
		                        			;
		                        		
		                        			Liver Diseases
		                        			;
		                        		
		                        			Muscle Cramp
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Ribavirin
		                        			;
		                        		
		                        			Sofosbuvir
		                        			
		                        		
		                        	
            
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