Thread by @DrGrimaldesJ

#IDEAS💡

DENGUE VIRUS > A HEPATOTROPE CAUSING HEPATOTOXICITY & HEPATITIS (HEPATOBILIARY TREE)🦟
ncbi.nlm.nih.gov/pmc/articles/P…
DENV and its effects on the liver:

DENV causes a disorder of the liver ranging from direct, hypoxic, ischemic viral injury to a dysregulated immune response resulting in apoptosis and necrosis

scirp.org/journal/paperi…
🔵Glutathione enzymes and liver damage in acute dengue viral infection:
Dengue viremia mainly affects the liver with viral toxicity or immunological injury.

🔵During acute DENV infection, the level of antioxidants such as glutathione peroxidase and glutathione reductase is reduced, while liver enzymes: aspartate transferase (AST) and alanine transferase (ALT) are elevated, suggesting induced oxidative stress. for the dengue virus

onlinelibrary.wiley.com/doi/10.1002/ej…
🔺IL-22 modulates the production of IL-17A and controls inflammation and tissue damage in experimental dengue infection:
DENV-induced acute liver failure could occur due to the release of inflammatory cytokines 👉 IL-22 and IL-17

ncbi.nlm.nih.gov/pmc/articles/P…
🔺TNF alpha, IL-2, IL-6 and IL-8 levels are also elevated in early dengue virus infection > while IL-5 and IL-10 increased later

🔹Various histological changes were observed in DENV-induced liver failure fatty change, hepatocyte necrosis, hyperplasia and destruction of Kupffer cells, Councilman bodies and mononuclear cell infiltrates in the portal space
sciencedirect.com/science/articl…

apps.who.int/iris/handle/10…
ncbi.nlm.nih.gov/books/NBK54816…
🔺According to a recent report, paracetamol overdose may play a crucial role in causing acute liver failure in DENV patients

🔥N-ACETYLCYSTEINE (#NAC) ANTIDOTE AGAINST LIVER TROPISM BY DENGUE?🔥
- Oxidative stress plays an important pathological role in the induction, progression, establishment and perpetuation of liver damage
NAC and RESV🍇 more potent antioxidants to treat liver disorders

#NAC 👉 inhibits NF-ΚB, ⬇️ IL2 - IL6, TNF alpha, TGF-β, modulates iNOS, stimulates Nrf2 and GSH

ncbi.nlm.nih.gov/pmc/articles/P…
🔸DENV infection causes activation of pathways other than NF-κB for the expression of inducible nitric oxide synthase and TNF-α in RAW264.7 cells

febs.onlinelibrary.wiley.com/doi/full/10.10…
🔹NAC ​​suppresses TNF-induced NF-κB activation through inhibition of IκB kinases

ncbi.nlm.nih.gov/pmc/articles/P…
🔸Role of TNF α, IL-6 and CXCL10 in the severity of dengue disease

pubmed.ncbi.nlm.nih.gov/27600005/
🔹Effect of chronic intermittent hypoxia on the expression of ligand-10 of the CXC chemokine in rat liver and the interventional effect of NAC

ncbi.nlm.nih.gov/pmc/articles/P…
🔸Effects of NAC ​​on cytokines in acute liver failure without acetaminophen: potential mechanism

journals.asm.org/doi/10.1128/JV…
🔹DENV targets Nrf2 for NS2B3-mediated degradation leading to increased oxidative stress and viral replication

ncbi.nlm.nih.gov/pmc/articles/P…
🔸Nitric oxide in dengue and hemorrhagic dengue fever: need or discomfort?
sciencedirect.com/science/articl…
🔹N-acetylcysteine ​​inhibits nitric oxide production in vivo by inducible nitric oxide synthase

dovepress.com/repurposing-of…
🔷Reuse of N-acetylcysteine for the treatment of acute liver failure induced by the dengue virus

bmcinfectdis.biomedcentral.com/articles/10.11…
✔️Use of intravenous NAC ​​in severe acute hepatitis due to severe dengue: case series

sciencedirect.com/science/articl…
✔️A recent study conducted in Thailand with mice has shown that NAC reduces dengue viral replication and oxidative damage to hepatocytes

ncbi.nlm.nih.gov/pmc/articles/P…
✔️Intravenous NAC ​​in dengue-associated acute liver failure

pubmed.ncbi.nlm.nih.gov/23817939/
✔️NAC ​​in children with acute liver failure complicating dengue viral infection

academic.oup.com/tropej/article…
✔️NAC ​​in children with dengue-associated liver failure

academic.oup.com/tropej/article…
✔️Clinical outcomes of children diagnosed with dengue-associated acute liver failure with or without treatment with NAC: a retrospective cohort study

tandfonline.com/doi/full/10.21…
✔️Use of NAC ​​for the treatment of acute liver failure induced by dengue virus

ncbi.nlm.nih.gov/pmc/articles/P…
Clinical and preclinical studies of N-acetylcysteine ​​in hepatitis induced by dengue virus

sciencedirect.com/science/articl…
🔵Reuse of NAC ​​drugs as an antiviral against dengue virus infection
-By inducing antiviral responses through interferon signaling

ncbi.nlm.nih.gov/pmc/articles/P…
✔️Potential benefit of NAC ​​in acute liver failure induced by DENV

- The mechanism of action of NAC in patients who recovered from AHI induced by dengue could be associated with its ability to increase the antioxidant defense system, its free radical scavenging activity, and its vasodilator activity that increases blood flow to the liver🎯

"Having solid studies of dengue hepatropism is why we propose NAC for acute dengue infection with warning signs and hemorrhagic"

Rómulo Daniel Grimaldes Jiménez, MD
Internal Medicine
02/15/2023

@DrLBoominathan @drakchaurasia @Nutrients_MDPI @Nature @TheLancet @Harvard @FrontCellInfect

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