Vitamin D deficiency may help spread of hepatitis B throughout liver

Contact: Dawn Peters sciencenewsroom@wiley.com 781-388-8408 Wiley

Researchers from Germany have found that low levels of vitamin D are associated with high levels of hepatitis B virus (HBV) replication. Findings published online in Hepatology, a journal of the American Association for the Study of Liver Diseases, suggest seasonal fluctuations in vitamin D and HBV levels point to a link in these variables among patients with chronic HBV.

While highly effective vaccines are available, HBV still remains one of the most significant infectious diseases worldwide. In fact, the World Health Organization (WHO) states that HBV is 50 to 100 times more infectious than human immunodeficiency virus (HIV). Furthermore WHO reports that two billion individuals have been infected with HBV, which is responsible for nearly 600,000 deaths each year. In the U.S. the Centers for Disease Control and Prevention (CDC) estimates that up to 1.4 million Americans are living with chronic HBV.

“Vitamin D helps maintain a healthy immune system and there is evidence of its role in inflammatory and metabolic liver disease, including infection with hepatitis C virus (HCV),” explains lead investigator Dr. Christian Lange from Johann Wolfgang Goethe University Hospital in Frankfurt. “However, the relationship between vitamin D metabolism and chronic HBV infection remains unknown and is the focus of our present study.”

Between January 2009 and December 2010, the team recruited 203 patients with chronic HBV who had not previously received treatment for their infection. Levels of 25-hydroxyvitamin D were measured from each participant. Patients co-infected with HCV, HIV, or hepatitis D; those with excessive alcohol use; and those with liver cancer or other malignancies were excluded.

Results show that 34% of participants had severe vitamin D deficiency (less than 10 ng/mL), 47% with vitamin D insufficiency (between 10-20 ng/mL) and 19% had normal levels of vitamin D (greater than 20 ng/mL). Further analyses indicate that the concentration of HBV in the blood, known as viral load, was a strong indicator of low vitamin D levels. In patients with HBV DNA less than 2000 IU/mL versus 2000 IU/mL or more, the levels of vitamin D were 17 and 11 ng/mL, respectively.

Researchers also determined that patients with the hepatitis B antigen (HBeAg) had lower levels of vitamin D than HBeAg negative participants. Inverse seasonal fluctuations between vitamin D and HBV levels were noted, which further suggests a relationship between the two variables.

“Our data confirm an association between low levels of vitamin D and high concentrations of HBV in the blood,” concludes Dr. Lange. “These findings differ from previous research of patients with chronic hepatitis C, which found no connection between vitamin D levels and concentration of HCV in the blood.” The authors propose further investigation of vitamin D as a therapeutic intervention for controlling HBV.

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This study is published in Hepatology. Media wishing to receive a PDF of this article may contact sciencenewsroom@wiley.com.

Full citation: “Low Vitamin D Serum Concentration is Associated with High Levels of Hepatitis B Virus (HBV) Replication in Chronically Infected Patients.” Harald Farnik, Jorg Bojunga, Annemarie Berger, Regina Allwinn, Oliver Waidmann, Bernd Kronenberger, Oliver T. Keppler, Stefan Zeuzem, Christoph Sarrazin and Christian M. Lange. Hepatology; (DOI: 10.1002/hep.26488) Published Online: May 22, 2013.

URL: http://doi.wiley.com/10.1002/hep.26488

About the Journal

Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published on is published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://wileyonlinelibrary.com/journal/hep.

About Wiley

Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.

Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s website can be accessed at http://www.wiley.com.

Antioxidant improves donated liver survival rate to more than 90 percent

Contact: Dawn Peters sciencenewsroom@wiley.com 781-388-8408 Wiley

Researchers from Italy have found that the antioxidant, N-acetylcysteine (NAC), when injected prior to harvesting of the liver, significantly improves graft survival following transplantation. Results published in the February issue of Liver Transplantation, a journal of the American Association for the Study of Liver Diseases (AASLD), suggest that the NAC effect on early graft function and survival is higher when suboptimal organs are used.

A 2010 World Health Organization (WHO) report estimates that 22,000 liver transplants were performed worldwide, with nearly 18,500 from deceased donors. According to the Organ Procurement and Transplantation Network (OPTN) close to 16,000 U.S. patients are currently on the waiting list for a liver. Nearly 18,500 deceased donor transplants were performed between January and October 2012 in the U.S. OPTN reports that roughly 7,000 livers were recovered from deceased donors during the same time period.

“Liver transplantation is the standard treatment for end-stage liver disease,” explains lead author Dr. Francesco D’Amico from Padova University in Italy. “Antioxidants such as NAC could potentially reduce damage to deceased donor livers, improving graft function.” Studies have shown that ischemia-reperfusion injury (IFI)—damage to the liver tissue when blood supply returns to the liver after lack of oxygen (ischemia)—often occurs during storage and preservation of donated livers, and impacts early graft function post-transplantation.

For the present study researchers assigned 140 organs to adult candidates with liver disease undergoing their first transplant. An NAC infusion of 30 mg/kg was administered to one hour prior to liver procurement and another infusion of 300 mg (150mg/kg liver weight) through the portal vein before cross-clamping. There were 69 transplant candidates who received an NAC infused organ and 71 patients who had a standard transplant without NAC.

Results indicate that graft survival rates at 3 and 12 months were 93% and 90%, respectively, for patients receiving NAC infused livers; rates were 82% and 70% in the control group. Post-transplant complication rates were 23% for the NAC group and 51% in the control group. Analysis of the 61 patients receiving suboptimal livers the incidence of organ dysfunction was lower in the NAC group compared to controls at 15% and 32%, respectively.

Dr. D’Amico concludes, “Our study was the first randomized trial to investigate the use of NAC antioxidant infusion during the liver procurement procedure. We propose that NAC be used during organ harvesting to improve liver transplantation outcomes, particularly with the increased use of suboptimal organs. NAC has a good safety profile and the very low cost per patient, make this protocol highly cost-effective in consideration of grafts survival, length of hospital stays and post operative complications. Moreover we are performing further analyses to determine beneficial effects on the other organ procured with NAC protocol.”

In a related editorial published this month in Liver Transplantation the authors from the University of California, San Francisco (UCSF) and OneLegacy (Organ Procurement Organization, Los Angeles) highlight the importance and rarity of deceased organ donor research, such as the study by D’Amico et al., despite the fact that randomized clinical trials are essential to evidence-based medicine. Dr. Claus Niemann from the Department of Anesthesia and the Department of Surgery, Division of Transplantation at UCSF said, “Well-controlled deceased donor research is crucial to uncovering superior clinical practices that improve organ utilization and transplant outcomes. However, researchers are currently operating in a regulatory and legal vacuum since no review and oversight policies are established.”

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For a copy of the study and editoral, please email sciencenewsroom@wiley.com.

Full citations: “Use of N-Acetylcysteine During Liver Procurement: A Prospective Randomized Controlled Study.” Francesco D’Amico, Alessandro Vitale, Anna Chiara Frigo, Donatella Piovan, Alessandra Bertacco, Domenico Bassi, Rafael Ramirez Morales, Pasquale Bonsignore, Enrico Gringeri, Michele Valmasoni, Greta Garbo, Enrico Lodo, Francesco Enrico D’Amico, Michele Scopelliti, Amedeo Carraro, Martina Gambato, Alberto Brolese, Giacomo Zanus, Daniele Neri and Prof. Umberto Cillo. Liver Transplantation; (DOI: 10.1002/lt.23527) Print Issue Date: February, 2013.

Editorial: “Deceased Organ Donor Research: The Last Research Frontier?” Thomas Mone, John Heldens and Claus U. Niemann. Liver Transplantation; (DOI: 10.1002/lt.23579) Print Issue Date: February, 2013.

About the Journal

Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. Since the first application of liver transplantation in a clinical situation was reported more than twenty years ago, there has been a great deal of growth in this field and more is anticipated. As an official publication of the AASLD and the ILTS, Liver Transplantation delivers current, peer-reviewed articles on surgical techniques, clinical investigations and drug research — the information necessary to keep abreast of this evolving specialty. For more information, please visit http://wileyonlinelibrary.com/journal/livertransplantation.

About Wiley

Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace.

Wiley is a global provider of content and content-enabled workflow solutions in areas of scientific, technical, medical, and scholarly research; professional development; and education. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s Web site can be accessed at http://www.wiley.com. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.

Mineral oil contamination in humans: White Paraffins Oils and aromatic components

Contact: Rabea Kapschak
rkapschak@wiley.com
49-062-016-06533
Wiley-Blackwell

Mineral oil contamination in humans: A health problem

From a quantitative standpoint, mineral oil is probably the largest contaminant of our body. That this contaminant can be tolerated without health concerns in humans has not been proven convincingly. The current Editorial of the European Journal of Lipid Science and Technology reflects on this and concludes that this proof either has to be provided or we have to take measures to reduce our exposure – from all sources, including cosmetics, pharmaceuticals and the environmental contamination.

In the Ukraine recently around 100,000 tonnes of sunflower oil were contaminated with mineral oil at concentrations often above 1000 mg/kg. Much of the contaminated oil was withdrawn, but there are products on the market which were produced before this contamination was detected; and this autumn there are still several 10,000 tonnes of contaminated oil in the Ukraine and other parts of the world. To protect consumers, a broad analytical campaign was initiated throughout Europe. The European Commission decided to apply a legal limit of 50 mg/kg to the mineral paraffins in Ukrainian sunflower oil and in September 2008 it organized a workshop together with the Official Food Control Authority of Zurich, Switzerland, to promote this campaign.

The editorial by Dr. Koni Grob from the Official Food Control Authority of the Canton of Zurich, Switzerland, titled “Does the Ukrainian sunflower oil contaminated with mineral oil wake up sleeping dogs?” discusses the situation. Dr. Koni Grob says that in many more foods more than 50 mg/kg mineral oil components from other sources will be found and the enforcement authorities will then be in difficulty to decide how to react. Certain edible oils, but also certain other foods, like canned fish, frequently contain more than 50 mg/kg mineral oil components, some products us much as 1000 mg/kg. Although known for some time, so far no measures were taken to stop this. He continued, our lab works for the safety of the consumers. Presently there is insufficient knowledge about potential negative effects of mineral oil on human health. We are heading for data regarding the material we are exposed to and which is accumulated in our bodies, in order to provide toxicological data for an improved safety evaluation.”

It has been shown that the molecular mass of the mineral paraffins resorbed by our body is higher than assumed by the safety evaluation of the European Food Safety Authority (EFSA). Further, probably a majority of the mineral oil products are not “white paraffin oils”: they easily contain 30 % aromatic components, a substantial portion being alkylated adding to the health risk. This unerringly questions the current official safety evaluation – which, admittedly, is a difficult task because of the complexity of the material. It can only be hoped that the mineral oil contamination of the Ukrainian sunflower oil and the inconsistencies regarding the effects of mineral oil on the human body will make the responsible industry, science and authorities more aware of this smouldering problem.

 

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This editorial is published in the November 2008 issue of European Journal of Lipid Science and Technology (Vol. 110, Issue 11, 2008). The article is available on Wiley InterScience: http://dx.doi.org/10.1002/ejlt.200800234

European Journal of Lipid Science and TechnologyLipids, fats and oils play an ever increasing role in many aspects of health, science and technology. The European Journal of Lipid Science and Technology focuses on the scientific and geographical integration of this varied spectrum ranging from lipidomics, nutrition and health to analytics, biotechnology and process engineering as well as chemistry and physical chemistry. The journal is the official organ of the European Federation for the Science and Technology of Lipids (Euro Fed Lipid).

About Wiley-Blackwell

Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley’s Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit www.blackwellpublishing.com or http://interscience.wiley.com.

About Wiley

Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Since 1901, Wiley and its acquired companies have published the works of more than 350 Nobel laureates in all categories: Literature, Economics, Physiology/Medicine, Chemistry and Peace.

Our core businesses include scientific, technical, medical and scholarly journals, encyclopedias, books, and online products and services; professional/trade publishes books, subscription products, training materials, and online applications and websites; and educational materials for undergraduate and graduate students and lifelong learners. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s Web site can be accessed at http://www.wiley.com. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.