Oral nitrate reductase activity is not associated with development of non-alcoholic fatty liver disease [NAFLD] and non-alcoholic steatohepatitis [NASH]: a pilot study

NAFLD/NASH is a manifestation of metabolic syndrome and is associated with obesity/overweight. Not all obese/overweight individuals develop NASH. Gastro-esophageal reflux disease [GERD] is considered a gastrointestinal manifestation of the metabolic syndrome and is associated with obesity/ overweight. Again not all obese/overweight individuals develop GERD. Recent data show association of dietary nitrate content and oral nitrate reductase activity [NRA] with GERD. Nitrates need to be converted to nitrite [done in human beings by nitrate reductase of oral bacteria exclusively] to be active in metabolic pathways. To assess the relation between NASH/NAFLD and oral NRA. Oral NRA was measured in individuals with NASH [compatible abdominal ultrasound and two elevated ALT/AST levels over six months] and was compared with that of those without NASH. Oral NRA was measured according to a previously reported protocol. Eleven NASH patients and twelve controls were enrolled. Mean oral NRA activity were 2.82 vs. 3.51 microg nitrite-N formed per person per minute for cases and controls respectively [p=0.46]. According to our data, oral nitrite production is not different between individuals with and without NASH.

Comparison of the effect of non-antifungal and antifungal agents on Candida isolates from the gastrointestinal tract

Non-antifungal drugs appear promising in treatment of opportunistic infections of Candida spp. that are often resistant to current antifungals. The broth macrodilution method [NCCLS M27-P document] was used to compare the antifungal activity of trifluoperazine, pro-pranolol, and lansoprazole with that of ketoconazole and amphotericin B, using 50 yeast isolates from the Gl tract. The minimum fungicidal concentrations [MFCs], resistance rates and the time required for fungicidal activity of the drugs [2 - 48 hours] were determined. The most effective antifungal activity was exhibited by trifluoperazine. Its MFC was 32 microg/mL for Candida albicans [3.3% resistance] and Candida spp. [0% resistance] yeasts, and 64 ug/mL for Candida tropicalis with 10% resistance. The MFC for C. albicans and Candida spp. was comparable to that of ketoconazole. However, the time required for the inhibitory effect [6 hr] was shorter than that of ketoconazole [48 hr] or amphotericin B [24 hr]. The time required for the inhibitory activity on C. tropicalis was 24 hr, which was shorter than that of ketoconazole and amphotericin B [48 hr]. A considerable number [40%] of Candida spp. showed resistance to ketoconazole, and 20% of C. tropicalis showed resistance to amphotericin B. Trifluoperazine, an antipsychotic drug, exhibited effective antifungal activity with the MFC, comparable to ketoconazole [32 microg/mL]. Among the three yeast groups, C. tropicalis showed resistance to trifluoperazine and amphotericin B, and Candida spp. was considerably resistant to ketoconazole. Trifluoperazine could be considered as an alternative antifungal when encountering Candida spp. resistant to current antifungals