Hepatoprotective drugs for prevention of liver injury resulting from anti-tuberculosis treatment:A meta-analysis of cohort studies

Background:The incidence of liver injury caused by anti-tuberculous(TB)drugs is very high.However,owing to a lack of sufficient evidence,preventive use of hepatoprotective drugs is not yet recommended.Therefore,we aimed to assess the protective effect of hepatoprotective drugs for anti-TB drug-induced liver injury.Methods:We conducted a literature search in China Biology Medicine disc,China National Knowledge Infras-tructure,WanFang,Chinese Scientific and Technological Journal,PubMed,Cochrane Library,Web of Science,and Embase.We performed meta-analysis using R 4.0 and Review Manager 5.3 software.Results:A total of 18 studies involving 3589 patients from 2 groups were included.Use of hepatoprotective drugs contributed to a lower incidence of liver injury as compared with conventional anti-TB treatment alone(relative risk[RR]=0.39,95%confidence interval[CI]:0.28-0.53,p<0.001).In subgroup analysis,significant protective effects were noted for mild liver injury(RR=0.30,95%CI 0.15-0.58),moderate(or severe)liver injury(RR=0.35,95%CI 0.19-0.65),and liver injury within 2-4 weeks(RR=0.37,95%CI 0.19-0.71).We also found a statistically significant difference in the incidence of drug withdrawal(RR=0.58,95%CI 0.34-0.97,p=0.040).Conclusions:Our results demonstrate that hepatoprotective drugs are effective in preventing liver injury in pa-tients receiving anti-TB treatment,to some extent.

Liver injury in COVID-19: A minireview

In December 2019,an outbreak of unexplained pneumonia was reported in Wuhan,China.The World Health Organization officially named this disease as novel coronavirus disease 2019(COVID-19).Liver injury was observed in patients with COVID-19,and its severity varied depending on disease severity,geographical area,and patient age.Systemic inflammatory response,immune damage,ischemia-reperfusion injury,viral direct damage,drug induce,mechanical ventilation,and underlying diseases may contribute to liver injury.Although,in most cases,mild liver dysfunction is observed,which is usually temporary and does not require special treatment,the importance of monitoring liver injury should be emphasized for doctors.The risk of COVID-19 infection of liver transplantation recipients caused more and more concerns.In this article,we aimed to review the available literature on liver injury in COVID-19 to highlight the importance of monitoring and treating liver injury in COVID-19.

Novel liver-specific nitric oxide(NO) releasing drugs with bile acid as both NO carrier and targeting ligand

Novel liver-specific nitric oxide（NO） releasing drugs with bile acid as both the NO carrier and targeting ligand were designed and synthesized by direct nitration of the hydroxyl group in bile acids or the 3-Ohydroxyl alkyl derivatives,with the intact 24-COOH being preserved for hepatocyte specific recognition.Preliminary biological evaluation revealed that oral administrated targeted conjugates could protect mice against acute liver damage induced by acetaminophen or carbon tetrachloride.The nitrate level in the liver significantly increased after oral administration of 1e while nitrate level in the blood did not significantly change.Co-administration of ursodeoxycholic acid（UDCA） significantly antagonized the increase of nitrate in the liver resulted by administration of 1e.

Traditional Chinese medicine for treatment of liver diseases: progress, challenges and opportunities

Traditional Chinese medicine （TCM） is commonly used in treating liver diseases worldwide, especially in China. The advantages of using TCM for treatment of liver diseases include： protecting hepatocytes, inhibiting hepatic inflammation and antifibrosis in the liver. In this article, we introduce TCM herbal preparations from the Chinese materia medica （such as Fuzheng Huayu） that are typically used for the treatment of liver diseases. Literature surrounding the mechanisms of TCM therapy for treatment of liver diseases is presented and discussed. We propose that side effects of herbal compounds are often under-appreciated, and that more care should be taken in the prescription of potentially hepatotoxic medicines. Further, to deepen the understanding of TCM mechanisms, new techniques and methodologies must be developed. Future studies will lead to the enhancement of clinical outcomes of TCM. As complementary and alternative therapies, TCMs will play an expanding role in the future of liver disease treatment.