Vegan Diet Advice Might Benefit Liver Enzymes in Nonalcoholic Fatty Liver Disease: an Open Observational Pilot Study.
- 作者列表："Chiarioni G","Popa SL","Dalbeni A","Senore C","Leucuta DC","Baroni L","Fantin A
BACKGROUND AND AIMS:The Western diet is rich in saturated fats, refined sugars and meat consistent with a high-energy load and secondary risk of increased metabolic diseases including nonalcoholic fatty liver disease (NAFLD). However, no data are available on potential benefit of vegan diets in NAFLD and/or nonalcoholic steatohepatitis (NASH). We aimed to study prospectively the effect of a vegan diet, excluding all animal products on liver chemistry in a group of consecutive NAFLD patients. METHODS:This was a prospective, pilot study run on 40 consecutive patients affected by NAFLD. Eight subjects refused to join the study for poor diet palatability, leaving 32 patients (19 males, mean age 50 years), with abnormal measures of liver function who agreed to adhere to a vegan diet for six months. The caloric intake was tailored by the dietitian to obtain a weight loss ≥5% of body weight in overweight patients [body-mass index (BMI) ≥25] and ranged from 1500 Kcal to 1800 Kcal. Patients were contacted monthly by phone to reinforce diet and lifestyle advice and were seen at the gastrointestinal clinic when doubtful about diet advice. RESULTS:At six-month follow-up, 6 subjects did not attend the clinic leaving only 26 patients for data analysis. Initial anthropometric values were mean weight 78 kg (range 52-95), mean body mass index (BMI) 26.8 Kg/m2 (range 20.3-31.2). Liver function tests showed mean ALT value 99 U/L (SD±45), mean AST value 54 U/L (SD±44), mean GGT value 160 U/L (SD±122), pre-treatment. After six months mean body weight was 73 Kg (range 52-87), mean BMI was 25.2 Kg/m2 (range 20.3-29.7) (p<0.001 compared to baseline for both parameters). Liver enzymes improved to a mean of ALT value 36 U/L (SD±21), AST value 27 U/L (SD±10) and GGT value 55 U/L (SD±57), respectively (p<0.001 compared to baseline for all enzymes). Normalization of liver function tests as a whole was observed in 20/26 patients (76.9%). A loss of ≥ 5% of body weight was observed in 12 patients (46.1%), but it did not correlate with the normalization of liver function tests (p=0.5). CONCLUSIONS:Our data provide preliminary evidence of improved liver enzymes in NAFLD patients with a strict vegan diet and although our study sample is limited, decreased body weight did not seem critical to the outcome.
背景和目的: 西方饮食富含饱和脂肪、精制糖和肉类，符合高能量负荷和增加代谢性疾病 (包括非酒精性脂肪性肝病 (NAFLD)) 的次要风险。然而，没有关于NAFLD和/或非酒精性脂肪性肝炎 (NASH) 中素食饮食的潜在益处的数据。我们的目的是前瞻性研究纯素食的影响，排除所有动物产品对一组连续NAFLD患者的肝脏化学。 方法: 这是一项前瞻性、初步研究，连续对40例NAFLD患者进行研究。8名受试者因饮食适口性差拒绝加入研究，留下32名患者 (19名男性，平均年龄50岁)，肝功能指标异常，同意坚持纯素食六个月。由营养师定制热量摄入，以获得超重患者体重减轻 ≥ 5% [体重指数 (BMI) ≥ 25]，范围为1500 Kcal至1800 Kcal.每月通过电话联系患者以加强饮食和生活方式建议，当怀疑饮食建议时，在胃肠道诊所就诊。 结果: 在6个月的随访中，6名受试者没有参加临床，只留下26名患者进行数据分析。初始人体测量值为平均体重78千克kg (范围52-95)，平均体重指数 (BMI) 26.8Kg/m2 (范围20.3-31.2)。肝功能检查示: 治疗前ALT均值99 U/L (SD ± 45)，AST均值54 U/L (SD ± 44)，GGT均值160 U/L (SD ± 122)。六个月后，平均体重为73Kg (范围52-87)，平均BMI为25.2Kg/m2 (范围20.3-29.7) (与两个参数的基线相比p<0.001)。肝酶分别改善至平均ALT值36 U/L (SD ± 21) 、AST值27 U/L (SD ± 10) 和GGT值55 U/L (SD ± 57) (与所有酶的基线相比p<0.001)。在20/26例患者 (76.9%) 中观察到肝功能测试作为整体的正常化。在12例患者 (5%) 中观察到体重减轻 ≥ 46.1%，但其与肝功能测试的正常化无关 (p = 0.5)。 结论: 我们的数据提供了严格纯素饮食的NAFLD患者肝酶改善的初步证据，尽管我们的研究样本有限，但体重下降似乎对结果并不重要。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.