Glycyrrhizin Exerts Antioxidative Effects in H5N1 Influenza A Virus-Infected Cells and Inhibits Virus Replication and Pro-Inflammatory Gene Expression

Glycyrrhizin is known to exert antiviral and anti-inflammatory effects. Here, the effects of an approved parenteral glycyrrhizin preparation (Stronger Neo-Minophafen C) were investigated on highly pathogenic influenza A H5N1 virus replication, H5N1-induced apoptosis, and H5N1-induced pro-inflammatory responses in lung epithelial (A549) cells. Therapeutic glycyrrhizin concentrations substantially inhibited H5N1-induced expression of the pro-inflammatory molecules CXCL10, interleukin 6, CCL2, and CCL5 (effective glycyrrhizin concentrations 25 to 50 µg/ml) but interfered with H5N1 replication and H5N1-induced apoptosis to a lesser extent (effective glycyrrhizin concentrations 100 µg/ml or higher). Glycyrrhizin also diminished monocyte migration towards supernatants of H5N1-infected A549 cells. The mechanism by which glycyrrhizin interferes with H5N1 replication and H5N1-induced pro-inflammatory gene expression includes inhibition of H5N1-induced formation of reactive oxygen species and (in turn) reduced activation of NFκB, JNK, and p38, redox-sensitive signalling events known to be relevant for influenza A virus replication. Therefore, glycyrrhizin may complement the arsenal of potential drugs for the treatment of H5N1 disease

Urinary NT-proBNP levels and echocardiographic parameters for patent ductus arteriosus

OBJECTIVE: Patent ductus arteriosus (PDA) is common in preterm infants and is associated with significant morbidities. B type natriuretic peptide (BNP) is synthesized in the ventricles secondary to volume overload and excreted as urinary N-terminal pro-brain natriuretic peptide (NT-proBNP). STUDY DESIGN: We report an observational prospective study of 64 preterm infants with birth weight <= 1000 g. Echocardiographic parameters were obtained from clinical echocardiograms performed in the first week of life. Urinary NT-proBNP/creatinine ratios (pg mg(-1)) were measured on the same day of the echocardiograms. RESULTS: Infants with medium to large PDA (n = 39) had significantly higher NT-proBNP/creatinine levels compared with infants with small PDA (n = 10) (median (IQ range): 2333 (792-6166) vs 714 (271-1632) pg mg(-1), P = 0.01) and compared with infants with no PDA (n = 15) (2333 (792-6166) vs 390 (134-1085) pg mg(-1), P = 0.0003). Urinary NT-proBNP/creatinine ratios were significantly lower post treatment if PDA closed (n = 17), P = 0.001 or if PDA became smaller after treatment (n = 9), P = 0.004. Urinary NT-proBNP/creatinine levels correlated with ductal diameter (P <= 0.0001), but not with LA/Ao ratio (P = 0.69) or blood flow velocity through the ductus (P = 0.06). CONCLUSION: Our findings indicate that there is a positive correlation between ductal diameter and urinary NT-proBNP in preterm infants