Histological evaluation of the changes in the Blood-Testis Barrier for boraks use

AMAÇ: Günlük yaşantıda yaygın olarak kullanılan bor bileşiklerinin uzun süreli kullanımında değişik organlarda doza bağımlı toksik etki olabileceği yönünde bulgular mevcuttur. Bu amaçla çalışmamızda değişik dozlarda boraks kullanılan ratların testislerinde kan-testis bariyeri yapısında ve leydig hücre sayısında görülebilecek değişimi belirlemeyi amaçladık. GEREÇ VE YÖNTEM: Çalışmada her grupta 6’şar erkek rat bulunan toplam 4 grup oluşturuldu. Her gruptaki ratlara boraksın farklı dozları oral yoldan uygulandı. Deney sonrası alınan sol testisler histolojik olarak takip edilerek immunohistokimyasal olarak Claudin-1, Pan Cadherin ve Calretinin ile boyandı ve ışık mikroskobu ile değerlendirildi. BULGULAR: Testis örneklerinde Cadherin ekspresyonunun artan doza bağımlı azaldığı gözlendi. Bununla birlikte Claudin 1 ekspresyonunun gruplar arasında çok değişiklik göstermediği gözlendi. Leydig hücre sayısının ise bir kez LD50x2 doz boraks uygulanan ratlarda azalma gösterdiği gözlendi. SONUÇ: Elde edilen bulgular boraks kullanımının doza bağımlı olarak testislerde kan-testis bariyeri bileşenleri üzerine zararlı etkiler oluşturabileceğini göstermektedir. Bu etkiler uzun dönemde infertilite sorunlarına neden olabilme potansiyeline sahiptir. Bu nedenle bilhassa bor bileşenleri üretim merkezleri çevresinde olmak üzere çevre kirliliği yönünden önemli korunma tedbirleri alınmasının gerekli olduğunu düşünmekteyiz.OBJECTIVE: The long-term use of boron compounds commonly used in daily life has some dose-dependent toxic effects on different organs For this purpose, in our study, we aimed to determine the change in blood-testis barrier structure and the number of leydig cells in the testis of rats in which were given borax at different doses. MATERIAL AND METHODS: In our study, 4 groups, in each have 6 male rats were made. Different doses of borax were given orally to rats in each groups. After the experiment, the left testis was excised, histologically processed and stained with Claudin-1, Pan cadherin and Calretinin immunohistochemically and evaluated under light microscopy. RESULTS: In testis slides, it was determined that Cadherin expression decreased parallel to borax doses. However, it was observed that the expression of Claudin 1 did not change much between the groups. The number of Leydig cells was observed to decrease in rats administered once with an LD50x2 dose. CONCLUSIONS: The findings suggest that the use of borax may be deleterious to the blood-testis barrier components in the testes. These effects have the potential to cause long term infertility problems. For this reason, we consider that it is necessary to take important preventive measures in terms of environmental pollution, especially around boron components production centers

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

The relationship between the use of nucleos(t)ide analogs and metabolic parameters in patients with chronic hepatitis B

OBJECTIVE: In the treatment of chronic hepatitis-B (CHB), although viral replication load is reduced with the use of nucleos(t)ide analogs, the risk of cirrhosis and hepatocellular carcinoma (HCC) remains. We aimed to investigate the relationship between metabolic syndrome (MetS) and CHB of nucleos(t)ide analogs, which are effective in mortality-morbidity. PATIENTS AND METHODS: In patients who applied to the gastroenterology outpatient clinic between 2021 and 2022, we compared inactive HBsAg-positive patients who did not receive treatment with nucleos(t)ide analogs [entecavir (ETV), lamivudine (LAM), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF)] and medical treatment. Demographic characteristics of the patients were recorded. Lipid profile, Hemoglobin A1c (HbA1c), and HOMA-IR were recorded. The presence of hepatosteatosis was graded ultrasonographically. APRI, Forns Index, and FIB-4 score, which are indicators of non-invasive liver fibrosis, were evaluated. RESULTS: Of the 265 patients, 55.5% (n=147) were males and 44.5% (n=118) were females. The ages of the participants ranged from 18 to 80, with a mean age of 46.54±14.03. It was observed that 62.3% (n=165) of the cases received medical treatment. When the drugs used by those receiving medical treatment were examined, 70.3% (n=116) TDF, 6.1% (n=10) TAF, 3% (n=5) LAM, and 20.6% (n=34) ETV, LDL, HDL, and total cholesterol measurement values of those who received medical treatment were lower, while HOMA-IR values were higher compared to those who did not receive the medical treatment. While the HbA1c value of the patients using ETV was found to be high, the liver stiffness indicator scores of those using TDF were found to be significantly higher. CONCLUSIONS: In this study, in patients with CHB, it has been shown that medical treatment also affects MetS parameters

Recommendations for hepatitis B immunoglobulin and antiviral prophylaxis against hepatitis B recurrence after liver transplantation

The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transplantation is considered as the standard of care for prophylaxis against hepatitis B virus recurrence. However, the recommended doses, route of administration, and duration of HBIG administration remain unclear. Moreover, hepatitis B immunoglobulin-free prophylaxis with potent nucleos(t)ide analogs has shown promising disease outcomes in preventing hepatitis B virus recurrence. The current recommendations, produced by the Turkish Association for the Study of the Liver, Acute Liver Failure and Liver Transplantation Special Interest Group, suggest a reduced need for hepatitis B immunoglobulin administration with effective long-term suppression of hepatitis B virus replication using potent nucleos(t) ide analogs after liver transplantation

Recommendations for hepatitis B immunoglobulin and antiviral prophylaxis against hepatitis B recurrence after liver transplantation

The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transplantation is considered as the standard of care for prophylaxis against hepatitis B virus recurrence. However, the recommended doses, route of administration, and duration of HBIG administration remain unclear. Moreover, hepatitis B immunoglobulin-free prophylaxis with potent nucleos(t)ide analogs has shown promising disease outcomes in preventing hepatitis B virus recurrence. The current recommendations, produced by the Turkish Association for the Study of the Liver, Acute Liver Failure and Liver Transplantation Special Interest Group, suggest a reduced need for hepatitis B immunoglobulin administration with effective long-term suppression of hepatitis B virus replication using potent nucleos(t)ide analogs after liver transplantation

Recurrence and occurrence of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment for chronic hepatitis C in patients with advanced liver disease: Turkish multi-center early access program

Bu çalışma, 11-15, Nisan 2018 tarihlerinde Paris[Fransa]’da düzenlenen International Liver Congress (ILC) Kongresi‘nde bildiri olarak sunulmuştur.European Assoc Study Live