Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:2.6.1.2 (alanine aminotransferase)
26,722 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We used a PCR method to develop a diagnostic assay for the detection of cytomegalovirus (CMV) DNA in infantile hepatitis, which has been suggested to be associated with CMV infection. CMV DNA was detected in 25 (58.1%) of 43 patients with elevated serum alanine aminotransferase (ALT) levels but no jaundice, and no hepatitis B or C as assessed by conventional PCR. None of the samples from 97 healthy infants tested positive for CMV DNA. We assayed CMV DNA quantitatively in blood using a real-time PCR system that allowed reproducible detection of at least 10 copies of CMV DNA. When 1 microg of DNA from each blood sample was used in this system, a good correlation was obtained between the calculated and measured copy numbers of CMV DNA. This system detected CMV DNA in 29 patients (67.4%) with liver dysfunction. Serial studies in patients with liver dysfunction revealed that CMV DNA copy number decreased, ultimately to below 10, as the ALT levels normalized. In contrast, no CMV DNA copies were detectable by the real-time system in any of the samples from control subjects. These results highlight the usefulness of detecting CMV DNA in the diagnosis of infantile hepatitis and indicate that the real-time quantitative PCR assay may be a valuable tool for monitoring CMV-associated infantile hepatitis.
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PMID:Quantitative evaluation of cytomegalovirus DNA in infantile hepatitis. 1138 Aug

The variable manifestations of infectious mononucleosis rarely cause clinicians to suspect primary Epstein-Barr virus or cytomegalovirus infection; consequently, costly diagnostic tests and unnecessary treatments are undertaken. Seventeen cases of clinically atypical and 11 cases of clinically typical infectious mononucleosis were diagnosed through screening for atypical and apoptotic lymphocytes in the peripheral blood samples by means of an automated hematologic analyzer. Atypical and typical cases did not differ significantly with respect to peripheral white blood cell counts; percentages of lymphocytes, atypical lymphocytes, CD4(+) lymphocytes, human leukocyte antigen--DR positivity in CD3 lymphocytes, or apoptotic cells in blood smear after incubation; or levels of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase. Only the percentage of CD8(+) lymphocytes was significantly higher in patients with typical infectious mononucleosis than it was in patients with atypical infectious mononucleosis. Because certain atypical cases of infectious mononucleosis display laboratory abnormalities that are characteristic of typical infectious mononucleosis, enhanced awareness can help in the diagnosis.
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PMID:Diagnosis of atypical cases of infectious mononucleosis. 1138 99

A new DNA virus, referred to as SEN virus (SEN V), has been isolated and is associated with blood-product transfusion and possibly Non A to Non E hepatitis. We performed a cross-sectional analysis of SEN V in liver transplant recipients at our center. Polymerase chain reaction was used to test for 2 genotypes of SEN V (SEN V:C/H and SEN V:D) in 58 unselected patients. Comparisons were made between SEN V--positive and SEN V--negative groups in terms of age, time posttransplantation, indications for transplantation, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and cytomegalovirus and Epstein-Barr virus status. Thirty of 58 transplant recipients (51.7%) were SEN V positive; 15.5% were positive for SEN V:C/H, 24.1% for SEN:D, and 12.1% for both strains. No significant differences were found based on primary indication for transplantation, including hepatitis C virus (HCV). Of the 14 of 21 patients with HCV seropositivity and HCV reinfection, 79% were positive for SEN V (P =.02). There was no difference in the proportion of patients with abnormal serum ALT and/or AST levels. A trend for the SEN V--positive group to have a greater mean ALT level (82 v 41 U/L; P =.067) was attributable to the subgroup with HCV recurrence because there was no difference in mean ALT levels (34.9 v 34.5 U/L; P =.968) in non--HCV-infected transplant recipients. Even in the subgroup (n = 14) with recurrent HCV, there was no statistically significant difference in mean ALT levels (140 v 105 U/L; P =.665). Age and cytomegalovirus or Epstein-Barr virus status were not significantly different between the 2 groups, but a significant difference in posttransplantation time was noted (16.8 v 32 months; P =.021). We conclude that SEN V is common among liver transplant recipients but does not appear to cause graft dysfunction as an isolated agent. There is a suggestion that SEN V may be associated with HCV recurrence, but we did not detect biochemical differences attributable to SEN V.
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PMID:A cross-sectional study of SEN virus in liver transplant recipients. 1144 81

AIM:To investigate the role of blood transfusion in TT viral infection(TTV).METHODS:We retrospectively studied serum samples from 192 transfusion recipients who underwent cardiovascular surgery and blood transfusion between July 1991 and June 1992. All patients had a follow-up every other week for at least 6 months after transfusion. Eighty recipients received blood before screening donors for hepatitis C antibody (anti-HCV), and 112 recipients received screened blood. Recipients with alanine aminotransferase level > 2.5 times the upper normal limit were tested for serological markers for viral hepatitis A, B, C, G, Epstein-Barr virus and cytomegalovirus. TTV infection was defined by the positivity for serum TTV DNA using the polymerase chain reaction method.RESULTS: Eleven and three patients, who received anti-HCV unscreened and screened blood, respectively, had serum ALT levels > 90IU/L. Five patients (HCV and TTV 1; HCV, HGV, and TTV 1; TTV 2; and CMV and TTV 1) were positive for TTV DNA, and four of them had sero conversion of TTV DNA.CONCLUSION:TTV can be transmitted via blood transfusion.Two recipients infected by TTV alone may be associated with the hepatitis. However, whether TTV was the causal agent remains unsettled, and further studies are necessary to define the role of TTV infection in chronic hepatitis.
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PMID:TT viral infection through blood transfusion: retrospective investigation on patients in a prospective study of post-transfusion hepatitis. 1181 26

Forty-one living donor liver transplantations (LDLT), including 11 pediatric and 30 adult recipients, were performed in Okayama University Hospital. Thirty-seven patients survive (overall survival rate 90.2%). Postoperative infection and rejection were analyzed. The incidence of bacterial and cytomegalovirus infection was 26.8% and 22%, respectively, but no patient developed lethal infection. Posttransplant lymphoproliferative disease occurred in 3 recipients who received additional pre- or postoperative intensive immunosuppressive therapy. Even though all recipients were administered a tacrolimus-based double or triple regimen including prophylactic programmed pulse therapy (methylpredonisone 10 mg/kg, days 5 to 7), 30 rejection episodes were observed in 19 patients(46.3%). Two recipients died of both steroid- and OKT-3-resistant rejection. Routine daily Doppler ultrasonography (US) revealed the presence of early severe rejection with hepatic hemodynamic changes in 7 patients. Patients exhibiting rejection with hemodynamic changes had a significantly shorter incubation period (8.8 +/- 2.2 vs 38.7 +/- 29.6 days, p < 0.01), more severe histological features(rejection activity index, 6.1 +/- 1.2 vs 3.0 +/- 0.5, p < 0.001), and higher peak alanine aminotransferase value (883 +/- 354 IU/L vs 198 +/- 115 IU/L, p < 0.01) than in those exhibiting rejection without hemodynamic changes. Diagnostic programmed pulse therapy plus frequent routine Doppler US may be useful in the diagnosis of and therapy for earlier and more severe acute rejection in LDLT.
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PMID:[Infection and rejection]. 1204 80

Contrary to the present practice of measurement of cardio-vascular risk factors or inflammatory risk factors such as C-Reactive Protein (CRP) from a blood sample from the vein of one arm, by using the Bi-Digital O-Ring Test Resonance Phenomena between 2 identical substances, one can non-invasively detect the approximate location on the body of abnormally increased risk factors in just 2 minutes, by detecting the resonance with L-Homocystine, even when blood CRP failed to detect any abnormality. This is performed by projecting a 0.5 to approximately 5mW red spectral laser beam with 560-670nm wavelength, to at least 6 standard parts of the body, when one of the control risk markers placed next to the laser beam also exists in the part of the body tested. It is generally believed that CRP is increased in the presence of acute myocardial infarct, chronic rheumatoid arthritis, ulcerative colitis, metabolic abnormalities such as often detected in diabetes, inflammation and underlying infection of the cardio-vascular system, and in some cancers. However, in our study, when the clinical significance of CRP and L-Homocystine was compared, we found that CRP often was not increased when there was extensive infection of Mycobacterium Tuberculosis as well as asymptomatic infection by Cytomegalovirus, Herpes Simplex Virus Type I, Human Herpes Virus Type 6, Borrelia Burgdorferi, or Chlamydia Trachomatis in the heart (and other parts of the body), particularly when there was liver cell dysfunction such as an increase in ALT. In contrast, L-Homocystine was often increased in the presence of localized infections of the heart and other parts of the body. For screening of Cardio-Vascular diseases by this method, 0.5mg of L-Homocystine as a control marker was found to be the most sensitive and reliable, compared with most effective amount of CRP, 0.5ng, for detecting early Cardio-Vascular problems due to various localized infections. About 0.5ng of cardiac Troponin T and cardiac Troponin I were also useful for detecting early stages of heart disease but they are not as sensitive as L-Homocystine. Once the pathogenic factors were identified, the effective medication was given, and the Selective Drug Uptake Enhancement Method (originally discovered by the first author in 1990) was applied after the effective drug was administered, to selectively deliver the medication to the pathological area, while reducing drug uptake to the normal parts of the body. As a result, the therapeutic effect was markedly accelerated.
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PMID:2 minute non-invasive screening for cardio-vascular diseases: relative limitation of C-Reactive Protein compared with more sensitive L-Homocystine as cardio-vascular risk factors; safe and effective treatment using the selective drug uptake enhancement method. 1293 59

Non-A-E hepatitis and acute cryptogenic hepatitis are the names given to the disease of patients with clinical hepatitis, but in whom serologic evidence of A-E hepatitis has not been found. Over a period of 8 years, we evaluated in Brazil 32 patients who fulfilled the criteria for this diagnosis in order to determine patterns of the clinical illness, laboratory parameters, or histologic features. Each patient was subjected to virologic tests to exclude A-E hepatitis and cytomegalovirus/Epstein-Barr virus infection. Drug-induced hepatitis and autoimmune disease were also excluded. Wilson's disease was excluded in young patients. The course of the disease was clinical/biochemical recovery in 3 months in 25 patients and persistent alanine aminotransferase (ALT) elevation in 7 patients. Three of these had chronic hepatitis, and one had severe fibrosis on liver biopsy. During the acute illness, mean peak ALT was 1267 IU/L, bilirubin was 4.0 mg/dL, and ferritin was 1393 IU/mL. GB virus type C (GBV-C) was found in six patients, and TT virus (TTV) in five patients. We conclude that, in Brazil, non-A-E hepatitis probably originates from still unidentified viruses. The course of the disease and the histologic patterns are similar to those recorded for known viruses. Continuous survey for the specific etiologic agents is needed.
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PMID:Clinical, histologic and serologic evaluation of patients with acute non-A-E hepatitis in north-eastern Brazil: is it an infectious disease? 1456 27

Allitridin (diallyl trisulfide), a main effective compound of Allium sativum (garlic), was previously shown to inhibit the expression of immediate-early antigens and viral proliferation of human cytomegalovirus (HCMV) in vitro. Here we have examined the prophylactic and therapeutic efficacy of allitridin in a non-lethal murine cytomegalovirus (MCMV) hepatitis in methylprednisolone-immunosuppressed BALB/c mice. Allitridin was administered at 25mg/kg per day (equal to the mean human dose) and 75 mg/kg per day in two regimens: prophylaxis plus therapy beginning at 2 days before infection and lasting for 18 days, and therapy lasting for 14 days initiated at 2 days after infection. Ganciclovir (GCV)-treated, infected, and non-infected mice served as controls. MCMV DNA load in the liver, plasma alanine aminotransferase (ALT) level and Knodell's histological activity index (HAI) score of liver section were evaluated. We found that MCMV DNA load was significantly decreased in all allitridin- and GCV-treated mice, compared with infected controls. Concomitantly, histopathological lesions in the liver and plasma ALT levels were reduced. Statistically, no significant differences were detected between the combined allitridin prophylaxis plus therapeutic and therapeutic groups regardless of dose and the GCV groups. Our results demonstrate the therapeutic efficacy of allitridin in mouse models with MCMV hepatitis.
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PMID:Experimental study on the prevention and treatment of murine cytomegalovirus hepatitis by using allitridin. 1467 May 86

Trimethoprim-sulfamethoxazole (TMP-SMZ) is one of the most commonly used antibiotics. Although many of its adverse effects are well recognized, TMP-SMZ related hepatotoxicity is considered rare and is usually characterized by cholestasis or mixed hepatocellular-holestatic reactions. In this study, we describe the case of a previously healthy young man with acute fulminant liver failure caused by TMP-SMZ. The patient presented with complaints of 'flu-like' symptoms with myalgia and fever after taking TMP-SMZ for 7 d for otitis externa. The patient subsequently developed fever, worsening jaundice, and a rash on his neck and chest. Liver enzymes peaked on day 3 with alanine aminotransferase (ALT) 11,549, aspartate aminotransferase (AST) 23,289, alkaline phosphatase 245, and total bilirubin 10.3 mg/dL, with a conjugated bilirubin of 8.3 mg/dL, prothrombin time (PT) 60.5 s, partial normalized ratio (PTT) 49 s, and international normalized ratio (INR) 7.5. Of note, acetaminophen level on admission was undetectable. Serology for hepatitis A, B, C, cytomegalovirus, HIV, toxoplasmosis, and blood cultures were all negative. The patient developed hepatic encephalopathy with hallucination on day 4. Laboratory tests revealed a serum ammonia level of 190 U, serum creatinine kinase (CK) 10,466 (42 on admission), serum creatinine 8.2 mg/dL (1.2 on admission), and significant metabolic acidosis. Renal ultrasound was unremarkable. The patient was started on hemodialysis for acute renal failure. Meanwhile, liver transplantation assessment was also initiated. On day 8 post-admission (15 d after taking TMP-SMZ), the patient received a successful orthotopic liver transplant.
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PMID:Successful orthotopic liver transplantation after trimethoprim-sulfamethoxazole associated fulminant liver failure. 1470 31

In recent years preclinical and clinical studies have been undertaken with selected monoclonal antibodies (MoAbs) either alone or coniugated to toxins in patients with several lymphoid malignancies, including chronic lymphocytic leukemia (CLL), prolymphocytic leukemia (PLL) and hairy cell leukemia (HCL). Two MoAbs, directed against CD20 antigen (Rituximab, RIT) and CD52 antigen (Campath-1H, alemtuzumab, ALT) demonstrate significant activity in CLL. The most notable success to data has been achieved with ALT, both in previously treated and untreated patients with CLL. ALT is a humanized rat IgG1 antibody that binds to the cell membrane of virtually all normal as well as malignant lymphocytes. In the vast majority of CLL patients ALT causes constant reduction of abnormal blood lymphocytes, usually in less than 4 weeks, and disappearance of CD5/CD19 co-expression cells from blood. The regression of lymphoid infiltration from other sites is less clear. ALT is also highly active in patients with CLL in progression, even refractory to fludarabine (FA). Hematological toxicity, especially long-lasting lymphocytopenia, was noted in the majority of patients. The most important clinical side effects of ALT treatment were infections, mainly herpes simplex virus and cytomegalovirus reactivation. RIT is also active in CLL in conventional doses. However some studies suggest that higher doses are more effective than standard doses, used routinely in other lymphoid malignancies. The activity of ALT and RIT in CLL patients resistant to FA and their synergistic interactions with cytotoxic drugs suggests that a combination of these agents may lead to further progress in the treatment of this disease. The T-cell variant of PLL has demonstrated impressive responses to ALT in several trials even if the patients were refractory to deoxycoformycin (DCF) and other agents. However, this MoAb is not curative, because all patients eventually relapsed. Consequently, treatment with ALT may need to be associated with stem cell transplantation to consolidate and maintain long-term remissions. Recently anti-CD22 and anti-CD25 immunotoxins have been investigated in purine analogues refractory or relapsed HCL. The presented results indicate that these agents are highly active and well tolerated even if the patients were resistant to 2-CdA or DCF.
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PMID:Monoclonal antibodies in the treatment of chronic lymphoid leukemias. 1510 4


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