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Fulltext Investigation of hepatitis A outbreak in district of Manjung, Perak, Malaysia, October 2012

Yusoff FA, Rahman RA, May LH, Budart SB, Sulaiman LH

Western Pac Surveill Response J, 2015 May 27;6(2):27-31.
PMID: 26306213 DOI: 10.5365/WPSAR.2015.6.1.012

In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures.

Matched MeSH terms: Hepatitis A/etiology; Hepatitis A/epidemiology*
Fulltext Phytochemicals and biological activity of Tetracera scandens Linn. Merr. (Dilleniaceae): A short review

Nokhala A, Siddiqui MJ

J Pharm Bioallied Sci, 2020 07 18;12(3):217-222.
PMID: 33100780 DOI: 10.4103/jpbs.JPBS_192_19

Tetracera scandens is a southeast Asian shrub that belongs to family Dilleniaceae. Over the years, different parts of the plant have been used for the management of different diseases, including diabetes mellitus, hypertension, rheumatism, diarrhea, hepatitis, and inflammation. This variety of medical indications has attracted the attention of many researchers to this plant species, leading to the conduction of many research studies on different parts of the plant. These studies have confirmed some of the aforementioned activities of the plant, whereas other indications remain to be ascertained. This article is an attempt to summarize the studies conducted on T. scandens and to explore the isolated phytochemicals.

Matched MeSH terms: Hepatitis A
Fulltext A study to identify environmental health indicators within the Langat basin ecosystem

Jamal Hisham Hashim, Ruzita Shariff, Dayang Aminah Ali, Mohd Hasni Jaafar, Mazlin Mokhtar

Malaysian Journal of Public Health Medicine, 2002;2(2):36-42.
MyJurnal

Indicators, whether referred to as ecological, biological or environmental, help us in assessing environmental conditions. Hypothetically, joint influences are predicted of the parameters associated with the number of water-borne, food-borne and vector-borne cases in study areas. Regression analysis of the dependent variables in water—borne diseases such as Cholera, Typhoid, Dysentery and Hepatitis indicated that the total coly°orm, fecal colform, residual chlorine, mean monthly rainfall and temperature influence almost hay of the cases in the 3 District of Serernban. Thus, coordinated monitoring of physical, chemical and biological parameters is needed to continue to build databases and to develop models integrating environnrental and social conditions, consequences and costs.

Matched MeSH terms: Hepatitis A
Fulltext A predictive method for hepatitis disease diagnosis using ensembles of neuro-fuzzy technique

Nilashi M, Ahmadi H, Shahmoradi L, Ibrahim O, Akbari E

J Infect Public Health, 2018 10 04;12(1):13-20.
PMID: 30293875 DOI: 10.1016/j.jiph.2018.09.009

BACKGROUND: Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. Supervised data mining techniques have been successful in hepatitis disease diagnosis through a set of datasets. Many methods have been developed by the aids of data mining techniques for hepatitis disease diagnosis. The majority of these methods are developed by single learning techniques. In addition, these methods do not support the ensemble learning of the data. Combining the outputs of several predictors can result in improved accuracy in classification problems. This study aims to propose an accurate method for the hepatitis disease diagnosis by taking the advantages of ensemble learning.
METHODS: We use Non-linear Iterative Partial Least Squares to perform the data dimensionality reduction, Self-Organizing Map technique for clustering task and ensembles of Neuro-Fuzzy Inference System for predicting the hepatitis disease. We also use decision trees for the selection of most important features in the experimental dataset. We test our method on a real-world dataset and present our results in comparison with the latest results of previous studies.
RESULTS: The results of our analyses on the dataset demonstrated that our method performance is superior to the Neural Network, ANFIS, K-Nearest Neighbors and Support Vector Machine.
CONCLUSIONS: The method has potential to be used as an intelligent learning system for hepatitis disease diagnosis in the healthcare.

Matched MeSH terms: Hepatitis A
Fulltext A Hybridised Intelligent Technique for the diagnosis of medical diseases

Abdu Masanawa Sagir, Saratha Sathasivam

Pertanika Journal of Science & Technology, 2017;25(2):425-440.
MyJurnal

Medical diagnosis is the process of determining which disease or medical condition explains a person’s determinable signs and symptoms. Diagnosis of most diseases is very expensive as many tests are required for predictions. This paper aims to introduce an improved hybrid approach for training the adaptive network based fuzzy inference system (ANFIS). It incorporates hybrid learning algorithms least square estimates with Levenberg-Marquardt algorithm using analytic derivation for computation of Jacobian matrix, as well as code optimisation technique, which indexes membership functions. The goal is to investigate how certain diseases are affected by patient’s characteristics and measurement such as abnormalities or a decision about the presence or absence of a disease. In order to achieve an accurate diagnosis at this complex stage of symptom analysis, the physician may need efficient diagnosis system to classify and predict patient condition by using an adaptive neuro fuzzy inference system (ANFIS) pre-processed by grid partitioning. The proposed hybridised intelligent technique was tested with Statlog heart disease and Hepatitis disease datasets obtained from the University of California at Irvine’s (UCI) machine learning repository. The robustness of the performance measuring total accuracy, sensitivity and specificity was examined. In comparison, the proposed method was found to achieve superior
performance when compared to some other related existing methods.

Matched MeSH terms: Hepatitis A
Aetiology and classification of acute liver failure

Rosmawati M

Med J Malaysia, 2005 Jul;60 Suppl B:125-6.
PMID: 16108192
Matched MeSH terms: Hepatitis A/complications
Hepatitis A shifting epidemiology in South-East Asia and China

Barzaga BN

Vaccine, 2000 Feb 18;18 Suppl 1:S61-4.
PMID: 10683551

A review of the epidemiology of hepatitis A virus (HAV) infection over the last 20 years shows shifting patterns in the prevalence of antibodies to HAV (anti-HAV) throughout South-East Asia and China. A number of countries have shifted from high to moderate and from moderate to low endemicity, with a corresponding increase in the age of exposure from childhood to early adulthood. The changes have resulted from improvements in hygiene, sanitation and the quality of drinking water, reflecting improvements in living standards and socioeconomic progress. In general in the late 1970s and early 1980s, 85-95% of the population of developing countries like the Philippines, Korea, China and Thailand were anti-HAV-positive by age 10-15 years, compared with only about 50% in the more affluent countries like Malaysia and Singapore. In the early 1990s, 85-95% of the population were immune by age 30-40 years in the Philippines, Korea, China and Thailand, and by 50 years of age and above in Malaysia and Singapore. Similar trends were noted in Hong Kong, Taiwan and Japan. Exposure to HAV at a later age may be associated with an increase in hepatitis A morbidity and a greater propensity for outbreaks.

Matched MeSH terms: Hepatitis A/epidemiology*
Fulltext Review article : hepatitis A virus – a general overview

Yong HT, Son R

International Food Research Journal, 2009;16(4):455-467.
MyJurnal

Hepatitis A virus infection occurs globally and is causing a public health concern, primarily in developing countries due to its persistent circulation in the environment. The improved sanitary condition and increase in awareness of personal hygiene have led to the marked reduction of HAV prevalence in industrialized countries during childhood and to a shift of the infection towards adulthood. HAV is an environmentally stable, positive single stranded RNA virus that is primarily transmitted by the fecal-oral route, person to person contact or ingestion of contaminated food and drink. One of the main causes leading to HAV infection is epidemiologically linked to the consumption of raw or undercooked shellfish particularly oysters and clams. Due to their filter-feeding style, these shellfishes readily concentrate viruses from the surrounding water containing municipal sewage, and as a consequence pose a health threat to consumers. Therefore, development of detection techniques possessing the requisite sensitivity and specificity for the practical routine monitoring purposes is of great importance necessary for the protection of shellfish-consuming public. Nucleic acid based method such as reverse transcription PCR has emerged as the popular method of choice in view of its rapidity, accuracy and
sensitivity in contrary of the time-consuming conventional cell culture and hybridization techniques. However, detection of hepatitis A virus is firstly hampered by the non-cytophatic effect of wild type HAV strain, secondly, the low concentration of viral genome present in the environmental sample which requires effective isolation and concentration of virions and lastly the labor-extensive purification and thorough removal of the abundance of the PCR inhibitors which will unfavorably reduce the efficiency of PCR detection.

Matched MeSH terms: Hepatitis A; Hepatitis A virus
Fulltext Detection of virus-specific polymeric immunoglobulin A in acute hepatitis A, C, E virus serum samples using novel chimeric secretory component

Mohd Hanafiah K, Garcia ML, Barnes NC, Anderson DA

BMC Res Notes, 2018 Oct 01;11(1):688.
PMID: 30285838 DOI: 10.1186/s13104-018-3799-2

OBJECTIVE: To conduct a proof-of-concept study on preferential binding of polymeric IgA (pIgA) using a novel recombinant rabbit/human chimeric secretory component (cSC) and preliminary assessment of the diagnostic potential of virus-specific pIgA in discriminating acute hepatitis A, E, and C (HAV, HEV, HCV) patients and uninfected controls using an indirect enzyme-linked immunoassay.
RESULTS: cSC binds > 0.06 μg/ml of purified human and mouse pIgA with negligible cross-reactivity against IgM and IgA. Virus-specific pIgA was significantly higher in serum of acute HAV (n = 6) and HEV (n = 12) patients than uninfected samples (HEV: p

Matched MeSH terms: Hepatitis A/blood*; Hepatitis Antibodies/blood*
Fulltext Review of the trends and causes of food borne outbreaks in Malaysia from 1988 to 1997

Meftahuddin T

Med J Malaysia, 2002 Mar;57(1):70-9.
PMID: 14569721 MyJurnal

This paper examines the trend and possible contributing factors for the occurrence of the food borne diseases outbreaks in Malaysia. These diseases mainly are cholera, typhoid fever, hepatitis A, dysentery and food poisoning. The outbreaks still occur sporadically in certain high risk areas throughout the country. The incidence rate of all the other three major food borne diseases steadily declined from the year 1988 to 1997 except for food poisoning and cholera. Statistic of food poisoning from the year 1996 to 1997 showed that 66.5% of the outbreak occurred in schools whereas only 0.4% originated from the contaminated food sold at various public food outlets. The school age group is always more affected than the general population. Amongst the contributing factors identified are related to unhygienic food handling practices followed by inadequate safe water supply and poor environmental sanitation. A multisectoral approach between Ministry of Health and other government agencies or private agents needs to be undertaken in the management of the food borne diseases in order to curb the incidences of food borne diseases in Malaysia.

Matched MeSH terms: Hepatitis A/etiology*; Hepatitis A/epidemiology*
Fulltext Robust model of systemic inflammation through Lipopolysaccharide

Khan H., Aamir K., Arya A.

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):50-50.
MyJurnal

Introduction: Systemic inflammation is the major clinical problem which is constellation of communicable and non-communicable infection equipped with acute to chronic inflammation. It may lead to unfavourable conditions for instance, systemic inflammatory syndrome, burns and sepsis. Systemic inflammation might rotate the steering towards vital clinical maladies including cardiomyopathy, neuroinflammation, hepatitis, liver and kidney diseases and even diabetes. In order to elucidate the molecular insights in these clinical implications, there is an intensive need
to design rodent model of systemic inflammation having close association with systemic inflammatory conditions in humans. Methods: Presently, lipopolysaccharide (LPS) induced systemic inflammatory rodent model is widely established, reproducible and acceptable among scientists. In this model animals are treated with intraperitoneal injection of LPS ranging from 1-10 mg/kg which leads to instant release of proinflammatory cytokines to provide robust model of systemic inflammation in order to elucidate pathological conditions and their in-depth mechanism to uncover the new anti-inflammatory therapeutic targets. Conclusion: Robust model would open new window to explore anti-inflammatory activities of phytochemicals, small molecules and drug candidates along with crosstalk of different signaling pathways at molecular level.

Matched MeSH terms: Hepatitis A
Fulltext Paper review of factors, surveillance and burden of food borne disease outbreak in Malaysia

Sharifa Ezat, W.P., Netty, D., Sangaran, G.

Malaysian Journal of Public Health Medicine, 2013;13(2):98-105.
MyJurnal

Food borne diseases like cholera, typhoid fever, hepatitis A, dysentery and food poisoning occur as the results of ingestion of foodstuffs contaminated with microorganisms or chemical. The true incidence of food borne disease in Malaysia is unknown, however the incidence is low ranging from 1.56 to 0.14 cases per 100,000 population and the food poisoning cases is on the rise as the evident by the incident rate of 62.47 cases per 100,000 population in 2008 and 36.17 in 2009. The rapid population growth and demographic shift toward ageing population, changing eating habit such as consumption of raw or lightly cooked food, long storage of such food, lack of education on basic rules of hygienic food preparation and food trading without appropriate microbiological safety procedure become contributing factors for food borne diseases. Food borne disease in Malaysia is in the rise and the direct and indirect cost management of FBD will become one of the most common issues to face by the government. The world is spending millions and millions in cost of treatment due to food borne diseases. The information on this paper was collected via findings of previous journals, data and statistics from the MOH of Malaysia and WHO websites. As a result, authors found that the prevention and management of the food borne disease outbreak needs to be addressed seriously.

Matched MeSH terms: Hepatitis A
Fulltext Advanced Chemical Reduction of Reduced Graphene Oxide and Its Photocatalytic Activity in Degrading Reactive Black 5

Wong CPP, Lai CW, Lee KM, Hamid SBA

Materials (Basel), 2015 Oct 19;8(10):7118-7128.
PMID: 28793623 DOI: 10.3390/ma8105363

Textile industries consume large volumes of water for dye processing, leading to undesirable toxic dyes in water bodies. Dyestuffs are harmful to human health and aquatic life, and such illnesses as cholera, dysentery, hepatitis A, and hinder the photosynthetic activity of aquatic plants. To overcome this environmental problem, the advanced oxidation process is a promising technique to mineralize a wide range of dyes in water systems. In this work, reduced graphene oxide (rGO) was prepared via an advanced chemical reduction route, and its photocatalytic activity was tested by photodegrading Reactive Black 5 (RB5) dye in aqueous solution. rGO was synthesized by dispersing the graphite oxide into the water to form a graphene oxide (GO) solution followed by the addition of hydrazine. Graphite oxide was prepared using a modified Hummers' method by using potassium permanganate and concentrated sulphuric acid. The resulted rGO nanoparticles were characterized using ultraviolet-visible spectrophotometry (UV-Vis), X-ray powder diffraction (XRD), Raman, and Scanning Electron Microscopy (SEM) to further investigate their chemical properties. A characteristic peak of rGO-48 h (275 cm-1) was observed in the UV spectrum. Further, the appearance of a broad peak (002), centred at 2θ = 24.1°, in XRD showing that graphene oxide was reduced to rGO. Based on our results, it was found that the resulted rGO-48 h nanoparticles achieved 49% photodecolorization of RB5 under UV irradiation at pH 3 in 60 min. This was attributed to the high and efficient electron transport behaviors of rGO between aromatic regions of rGO and RB5 molecules.

Matched MeSH terms: Hepatitis A
Fulltext Hepatoprotective Effects of Orthosiphon stamineus Extract on Thioacetamide-Induced Liver Cirrhosis in Rats

Alshawsh MA, Abdulla MA, Ismail S, Amin ZA

Evid Based Complement Alternat Med, 2011;2011:103039.
PMID: 21647311 DOI: 10.1155/2011/103039

Orthosiphon stamineus as medicinal plant is commonly used in Malaysia for treatment of hepatitis and jaundice; in this study, the ethanol extracts were applied to evaluate the hepatoprotective effects in a thioacetamide-induced hepatotoxic model in Sprague Dawley rats. Five groups of adult rats were arranged as follows: Group 1 (normal control group), Group 2 Thioacetamide (TAA) as positive control (hepatotoxic group), Group 3 Silymarin as a well-known standard drug (hepatoprotective group), and Groups 4 and 5 as high and low dose (treatment groups). After 60-day treatment, all rats were sacrificed. The hepatotoxic group showed a coarse granulation on the liver surface when compared to the smooth aspect observed on the liver surface of the other groups. Histopathological study confirmed the result; moreover, there was a significant increase in serum liver biochemical parameters (ALT, AST, ALP, and Bilirubin) and the level of liver Malondialdehyde (MDA), accompanied by a significant decrease in the level of total protein and Albumin in the TAA control group when compared with that of the normal group. The high-dose treatment group (200 mg/kg) significantly restored the elevated liver function enzymes near to normal. This study revealed that 200 mg/kg extracts of O. stamineus exerted a hepatoprotective effect.

Matched MeSH terms: Hepatitis A
CYP3A4*18 polymorphisms and anti-hepatitis A virus seroprevalence

Ahmad F, Che Hamzah NA, Mustaffa N, Hua GS

Hepatogastroenterology, 2011 07 15;58(110-111):1725-9.
PMID: 21940338 DOI: 10.5754/hge11107

BACKGROUND/AIMS: CYP3A4 is the major cytochrome in humans which shows reduced activity in chronic liver disease as well as in hepatic cirrhosis. The detection of this polymorphism may give an indication on the prognosis of patients having chronic viral hepatitis with superimposed hepatitis A infection. The aim of this study is to correlate the seroprevalence of anti-HAV antibodies in chronic liver disease patients having CYP3A4*18 polymorphisms.
METHODOLOGY: This is a prospective study where patients (n=119) blood was tested for anti-HAVIgG and CYP3A4*18 polymorphism.
RESULTS: The overall anti-HAV seroprevalence was 88.2%. The etiology of CLD was hepatitis B in 96 patients (80.7%) and hepatitis C in 23 patients (19.3%). There was a significant increase in the age of the prevalence of this disease after 30 years of age (p=0.008). CYP3A4*18 polymorphism was detected in 3 (2.5%) of the patients with chronic liver disease. However, there was no significant association between CP3A4*18 mutation and anti-HAV serology.
CONCLUSIONS: Age was the most important factor in determining anti-HAV positivity. It is concluded that CYP3A4*18 genetic polymorphism does not play a main role in influencing the seroprevalence of anti-hepatitis A among chronic viral hepatitis B and C liver disease patients.

Matched MeSH terms: Hepatitis A Antibodies/blood*
Aetiology of acute hepatitis in Malaysia

Tan DS, Dimitrakakis M, Zaini Rahman M, Fang R, Collett D, Ooi BG, et al.

Southeast Asian J. Trop. Med. Public Health, 1986 Jun;17(2):205-8.
PMID: 3024325

Icteric patients with clinical and biochemical evidence of liver disease, admitted into various hospitals in Malaysia, were investigated to determine the cause of their infection. Of these patients, 11.0% (16/145) were found positive for IgM anti-HAV (EIA), 4.1% (6/145) for IgM anti-HBc (EIA), 1.0% (1/102) for IgM anti-CMV (ELISA), 17.2% (16/64) for rising titres of leptospiral agglutinin, and none for heterophile antibody of EBV. Hepatitis NANB accounted for 67.9% of cases. The mean serum transaminases (ALT and AST) values in patients with hepatitis A and B were higher (more than 500IU) than in patients with leptospirosis or non-A, non-B hepatitis, whereas serum bilirubin levels were higher in patients with hepatitis A and leptospirosis than in patients with hepatitis B.

Matched MeSH terms: Hepatitis A/etiology
Fulltext The frequency of non-A, non-B hepatitis in acute and chronic liver disease

Ross IN, Madhavan HN, Tan SH, Abdul Rahim K

Med J Malaysia, 1985 Dec;40(4):301-6.
PMID: 3025569

Serological markers were used to determine the infective agents causing acute viral hepatitis in 246 patients. The frequencies of the five viral infections investigated were: non-A, non-B hepatitis - 99 patients (40.2%); hepatitis A - 98 patients (39.8%); hepatitis B - 43 patients (17.5%); cytomegalovirus - 4 patients (1.6%); and Epstein-Barr virus - 2 patients (0.8%). The log mean ages of presentation for the three predominant infections were: hepatitis A - 18 years; hepatitis B - 25 years; and non-A, non-B hepatitis - 30 years (F = 18.8, p =< 0.001). 52% of all cases were Malays (expected 32. 7%); 32% Chinese (expected 54.6%); and 16% Indians (expected 1l.5%) (X2 = 53, p = < 0.001). Hepatitis A virus infection was more common amongst Malays whilst non-A, non-B hepatitis was more frequent amongst Chinese and Indians. 28% of children <16 years) and 50% of adults had serological markers of previous hepatitis B infection. The variation in frequency for the different forms of hepatitis amongst the three main ethnic groups would suggest that socioeconomic and/or cultural factors are important in the propagation of acute viral hepatitis in Malaysia. HBsAg-negative chronic liver disease in our community may be a product of the high incidence of non-A, non-B hepatitis.

Matched MeSH terms: Hepatitis A/epidemiology
Fulltext Adaptive NKG2C+CD57+ Natural Killer Cell and Tim-3 Expression During Viral Infections

Kared H, Martelli S, Tan SW, Simoni Y, Chong ML, Yap SH, et al.

Front Immunol, 2018;9:686.
PMID: 29731749 DOI: 10.3389/fimmu.2018.00686

Repetitive stimulation by persistent pathogens such as human cytomegalovirus (HCMV) or human immunodeficiency virus (HIV) induces the differentiation of natural killer (NK) cells. This maturation pathway is characterized by the acquisition of phenotypic markers, CD2, CD57, and NKG2C, and effector functions-a process regulated by Tim-3 and orchestrated by a complex network of transcriptional factors, involving T-bet, Eomes, Zeb2, promyelocytic leukemia zinc finger protein, and Foxo3. Here, we show that persistent immune activation during chronic viral co-infections (HCMV, hepatitis C virus, and HIV) interferes with the functional phenotype of NK cells by modulating the Tim-3 pathway; a decrease in Tim-3 expression combined with the acquisition of inhibitory receptors skewed NK cells toward an exhausted and cytotoxic phenotype in an inflammatory environment during chronic HIV infection. A better understanding of the mechanisms underlying NK cell differentiation could aid the identification of new immunological targets for checkpoint blockade therapies in a manner that is relevant to chronic infection and cancer.

Matched MeSH terms: Hepatitis A Virus Cellular Receptor 2/immunology*
Fulltext KIM-1 as a Blood-Based Marker for Early Detection of Kidney Cancer: A Prospective Nested Case-Control Study

Scelo G, Muller DC, Riboli E, Johansson M, Cross AJ, Vineis P, et al.

Clin Cancer Res, 2018 Nov 15;24(22):5594-5601.
PMID: 30037816 DOI: 10.1158/1078-0432.CCR-18-1496

Purpose: Renal cell carcinoma (RCC) has the potential for cure with surgery when diagnosed at an early stage. Kidney injury molecule-1 (KIM-1) has been shown to be elevated in the plasma of RCC patients. We aimed to test whether plasma KIM-1 could represent a means of detecting RCC prior to clinical diagnosis.Experimental Design: KIM-1 concentrations were measured in prediagnostic plasma from 190 RCC cases and 190 controls nested within a population-based prospective cohort study. Cases had entered the cohort up to 5 years before diagnosis, and controls were matched on cases for date of birth, date at blood donation, sex, and country. We applied conditional logistic regression and flexible parametric survival models to evaluate the association between plasma KIM-1 concentrations and RCC risk and survival.Results: The incidence rate ratio (IRR) of RCC for a doubling in KIM-1 concentration was 1.71 [95% confidence interval (CI), 1.44-2.03, P = 4.1 × 10-23], corresponding to an IRR of 63.3 (95% CI, 16.2-246.9) comparing the 80th to the 20th percentiles of the KIM-1 distribution in this sample. Compared with a risk model including known risk factors of RCC (age, sex, country, body mass index, and tobacco smoking status), a risk model additionally including KIM-1 substantially improved discrimination between cases and controls (area under the receiver-operating characteristic curve of 0.8 compared with 0.7). High plasma KIM-1 concentrations were also associated with poorer survival (P = 0.0053).Conclusions: Plasma KIM-1 concentrations could predict RCC incidence up to 5 years prior to diagnosis and were associated with poorer survival. Clin Cancer Res; 24(22); 5594-601. ©2018 AACR.

Matched MeSH terms: Hepatitis A Virus Cellular Receptor 1/blood*
Fulltext Clinacanthus nutans (Burm. f.) Lindau Ethanol Extract Inhibits Hepatoma in Mice through Upregulation of the Immune Response

Huang D, Guo W, Gao J, Chen J, Olatunji JO

Molecules, 2015;20(9):17405-28.
PMID: 26393569 DOI: 10.3390/molecules200917405

Clinacanthans nutans (Burm. f.) Lindau is a popular medicinal vegetable in Southern Asia, and its extracts have displayed significant anti-proliferative effects on cancer cells in vitro. However, the underlying mechanism for this effect has yet to be established. This study investigated the antitumor and immunomodulatory activity of C. nutans (Burm. f.) Lindau 30% ethanol extract (CN30) in vivo. CN30 was prepared and its main components were identified using high-performance liquid chromatography (HPLC) and mass spectrometry (LC/MS/MS). CN30 had a significant inhibitory effect on tumor volume and weight. Hematoxylin and eosin (H & E) staining and TUNEL assay revealed that hepatoma cells underwent significant apoptosis with CN30 treatment, while expression levels of proliferation markers PCNA and p-AKT were significantly decreased when treated with low or high doses of CN30 treatment. Western blot analysis of PAPR, caspase-3, BAX, and Bcl2 also showed that CN30 induced apoptosis in hepatoma cells. Furthermore, intracellular staining analysis showed that CN30 treatment increased the number of IFN-γ⁺ T cells and decreased the number of IL-4⁺ T cells. Serum IFN-γ and interleukin-2 levels also significantly improved. Our findings indicated that CN30 demonstrated antitumor properties by up-regulating the immune response, and warrants further evaluation as a potential therapeutic agent for the treatment and prevention of cancers.

Matched MeSH terms: Hepatitis A/drug therapy*; Hepatitis A/immunology

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