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Protective effect of Thymic Humoral Factor on porcine serum-induced hepatic fibrosis and liver damage in Wistar rats
Ulises Osuna-Martínez*, Jorge Alberto Reyes-Esparza*, Vera L. Petricevich**, Rogelio Hernández-Pando***, Lourdes Rodríguez-Fragoso
,
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mrodriguez@uaem.mx
mrodriguezf@uaem.mx

Correspondence and reprint request:
* Facultad de Farmacia, Universidad Autónoma del Estado de Morelos. Cuernavaca, Morelos, México
** Facultad de Medicina, Universidad Autónoma del Estado de Morelos. Cuernavaca, Morelos, México
*** Departamento de Patología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">Liver fibrosis is a worldwide major medical problem and is associated with significant morbidity and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Hepatic fibrosis is the wound-healing response of a liver subjected to continuous liver injury and is associated with chronic inflammation and a variety of chemical factors commonly found in most chronic liver diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="p0010" class="elsevierStylePara elsevierViewall">There are several immunological mechanisms involved in liver fibrosis&#44; including inflammatory cell infiltration&#44; activation of hepatic stellate cells &#40;HSC&#41; and production of cytokines such as TNF-&#945;&#44; TGF-&#946; and IL-6 at early stage&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> the latter being a key element in local regulation of the fibrogenic respon-se&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> At an advanced state&#44; cytokines such as TNF-&#945; and TGF-&#946;&#44; growth factors like PDGF or chemokines such as MCP-1 are produced in high quantities and are involved in the progression of fi-brosis and liver failure&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="p0015" class="elsevierStylePara elsevierViewall">Different kinds of liver fibrosis animal models have been developed&#44; but most of them are post-necrotic hepatic fibrosis models&#46; The porcine serum &#40;PS&#41; induced hepatic fibrosis model is characterized by minor hepatocyte damage but intense immune response given the chronic administration of the heterogeneous serum&#46; This immunological response is regulated by MHC class II molecules and inflammatory cells&#44; which activate HSC-producing liver fibro-sis&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> These immunologic mechanisms make this an appropriate model for the evaluation of immuno-modulatory drugs&#44; since immune response is the key factor in the development of liver fibrosis&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">It has been reported that some immunomodulatory agents are able to modify liver injury from different etiology&#46; It has been shown that AM3&#44; a biological response modifier&#44; reverses the concurrent inflammatory system activation in peripheral blood and liver during experimental cirrhosis&#46; This leads to a reduction of hepatic fibrosis&#44; portal hypertension and peripheral vasodilatation&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Other agents&#44; like PI3K&#947; inhibitor&#44; a member of the class 1 PI3 kinases family&#44; interact with phospho-Akt and PIP3 at cell membrane level and prevent phosphorylation&#44; which leads to downstream cell signaling pathways associated with inflammation and immune functions&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="p0025" class="elsevierStylePara elsevierViewall">Thymic humoral factor &#40;THF&#41;&#44; a peptide produced in the thymus&#44; has a potent immunomodulatory effect on different components of the immune system&#46; It has been found that THF restores T cell growth factor<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and can modify IL-2 levels on human umbilical cord blood lymphocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> THF has been used&#44; along with &#945;-interferon or mitogen phytohaemagglutinin in patients with hepatitis B<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> and as monotherapy in hepatitis D<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> without adverse reactions&#59; THF also increases anti-viral activity against cytomegalovirus in animal models&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Because of all this&#44; we hypothesized THF had a potential therapeutic role in controlling liver damage and fibrosis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objective</span><p id="p0030" class="elsevierStylePara elsevierViewall">To evaluate THF effect during different stages in an immunological model of PS-induced rat liver injury and fibrosis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Materials and Methods</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Reagents and animals</span><p id="p0035" class="elsevierStylePara elsevierViewall">THF was synthesized by New England Peptide&#44; Gardner&#44; MA&#44; USA&#46; PS was purchased from Sigma-Aldrich&#44; USA&#46; Commercial kits were used for determining alanine aminotransferase &#40;ALT&#41;&#44; aspartate aminotransferase &#40;AST&#41;&#44; alkaline phosphatase &#40;ALP&#41; and gamma-glutamyltransferase &#40;&#947;-GT&#41;&#59; all kits were obtained from ELITech Group &#40;France&#41;&#46; Enzyme-linked immunosorbent assay &#40;ELISA&#41; kits were used to measure IL-6 and IL-10&#46; All kits were obtained from BD Biosciences &#40;San Diego&#44; California&#41;&#46;</p><p id="p0040" class="elsevierStylePara elsevierViewall">Seventy-two male Wistar rats &#40;110-130 g&#41; were purchased from Harlan Mexico&#44; S&#46;A&#46; de C&#46;V&#46; Animals were randomly housed in groups of six per cage and kept under controlled conditions &#40;24 &#176;C and 58&#37; humidity&#41; with alternating 12 h dark&#47;light cycles&#46; Animals were fed with a Rodent Laboratory Chow diet and had free access to food and water&#46; Before the study&#44; animals were subjected to 1-week acclimation&#46; All procedures were approved by the Institutional Animal Care and Use Committee of the Veterinary Medical School at the National Autonomous University of Mexico&#46; The experiments were conducted in accordance with the principles set forth in the Guide for the Care and Use of Laboratory Animals&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Animal model</span><p id="p0045" class="elsevierStylePara elsevierViewall">Liver injury and fibrosis were induced in male Wistar rats following Paronetto&#8217;s method&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Briefly&#44; 3&#46;5 mL&#47;kg of sterile PS were administered twice per week via intraperitoneal injection &#40;ip&#41; for eight weeks&#46; This model is characterized by a substantial immune response in the liver&#44; causing little hepatocyte damage and liver fibrosis after 8 weeks of PS administration&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pharmacological treatments and sample collection</span><p id="p0050" class="elsevierStylePara elsevierViewall">Animals were randomly distributed into the following groups &#40;<a class="elsevierStyleCrossRef" href="#f0005">Figure 1</a>&#41;&#58; groups 1&#44; 2&#44; 3 and 4 were evaluated at 30 days&#58;<ul class="elsevierStyleList" id="li0005"><li class="elsevierStyleListItem" id="list0005"><span class="elsevierStyleLabel">&#8226;</span><p id="p0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">1&#46; Control&#46;</span></span> 0&#46;5 mL of saline ip twice per 7 days for 30 days&#46;</p></li><li class="elsevierStyleListItem" id="list0010"><span class="elsevierStyleLabel">&#8226;</span><p id="p0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">2&#46; THF&#46;</span></span> 50 ng&#47;kg ip three times per 7 days for 15 days &#40;last 15 days of 30&#41;&#46;</p></li><li class="elsevierStyleListItem" id="list0015"><span class="elsevierStyleLabel">&#8226;</span><p id="p0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">3&#46; Liver damaged&#46;</span></span> 3&#46;5 mL&#47;kg of porcine-serum ip twice per 7 days for 30 days&#46;</p></li><li class="elsevierStyleListItem" id="list0020"><span class="elsevierStyleLabel">&#8226;</span><p id="p0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">4&#46; Liver damaged &#43; THF&#46;</span></span> Doses used in groups 2 and 3&#46;</p></li></ul></p><elsevierMultimedia ident="f0005"></elsevierMultimedia><p id="p0075" class="elsevierStylePara elsevierViewall">The groups 5&#44; 6&#44; 7 and 8 were evaluated at 60 days&#58;<ul class="elsevierStyleList" id="li0010"><li class="elsevierStyleListItem" id="list0025"><span class="elsevierStyleLabel">&#8226;</span><p id="p0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">5&#46; Control&#46;</span></span> 0&#46;5 mL of saline ip twice per 7 days for 60 days&#46;</p></li><li class="elsevierStyleListItem" id="list0030"><span class="elsevierStyleLabel">&#8226;</span><p id="p0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">6&#46; THF&#46;</span></span> 50 ng&#47;kg ip three times per 7 days for 30 days &#40;last 30 days of 60&#41;&#46;</p></li><li class="elsevierStyleListItem" id="list0035"><span class="elsevierStyleLabel">&#8226;</span><p id="p0090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">7&#46; Liver damaged&#46;</span></span> 3&#46;5 mL&#47;kg of porcine-serum ip twice per 7 days for 60 days&#46;</p></li><li class="elsevierStyleListItem" id="list0040"><span class="elsevierStyleLabel">&#8226;</span><p id="p0095" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">8&#46; Liver damaged &#43; THF&#46;</span></span> Doses used in groups 6 and 7&#46;</p></li></ul></p><p id="p0100" class="elsevierStylePara elsevierViewall">Finally&#44; groups 9&#44; 10&#44; 11 and 12 were evaluated at 90 days&#58;<ul class="elsevierStyleList" id="li0015"><li class="elsevierStyleListItem" id="list0045"><span class="elsevierStyleLabel">&#8226;</span><p id="p0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">9&#46; Control&#46;</span></span> 0&#46;5 mL of saline ip twice per 7 days for 90 days&#46;</p></li><li class="elsevierStyleListItem" id="list0050"><span class="elsevierStyleLabel">&#8226;</span><p id="p0110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">10&#46; THF&#46;</span></span> 50 ng&#47;kg ip three times per 7 days for 45 days &#40;last 45 days of 90&#41;&#46;</p></li><li class="elsevierStyleListItem" id="list0055"><span class="elsevierStyleLabel">&#8226;</span><p id="p0115" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">11&#46; Liver damaged&#46;</span></span> 3&#46;5 mL&#47;kg of porcine-serum ip twice per 7 days for 90 days&#46;</p></li><li class="elsevierStyleListItem" id="list0060"><span class="elsevierStyleLabel">&#8226;</span><p id="p0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold"><span class="elsevierStyleItalic">12&#46; Liver damaged &#43; THF&#46;</span></span> Doses used in groups 10 and 11&#46;</p></li></ul></p><p id="p0125" class="elsevierStylePara elsevierViewall">Rats were weighed and drug doses were adjusted accordingly once a week&#46;</p><p id="p0130" class="elsevierStylePara elsevierViewall">Groups of six rats each were euthanized under ether anesthesia after 30&#44; 60 and 90 days&#46; Blood samples were collected from the inferior vein cava and centrifuged for 10 min at 2&#44;000 rpm&#46; The serum was preserved at -80 &#176;C until analysis&#46; The liver was excised and preserved in different ways for further evaluation&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Biochemical analysis in serum</span><p id="p0135" class="elsevierStylePara elsevierViewall">The serum activity of ALT&#44; AST&#44; ALP and &#947;-GT was determined using a commercially available kit according to manufacturers&#8217; instructions&#46; Briefly&#44; 20 &#956;L &#40;for ALT and AST&#41;&#44; 10 &#956;L &#40;ALP&#41; or 5 &#956;L &#40;&#947;-GT&#41; of serum were mixed with 0&#46;2 mL of assay solution &#40;ALT&#44; AST and ALP&#41; or 0&#46;25 mL of &#947;-GT&#44; then measured in an absorbance microplate reader &#40;EL x 800 BioTek&#41; with the software Gen5 v&#46;1&#46;07&#46;5&#44; following the supplier&#8217;s protocol&#46; ALT&#44; AST&#44; ALP and &#947;-GT activity were expressed as an international unit per liter &#40;U&#47;L&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Quantification of IL-6 and IL-10 in serum</span><p id="p0140" class="elsevierStylePara elsevierViewall">IL-6 and IL-10 levels were evaluated by ELISA kit in accordance with the manufacturer&#8217;s protocol&#46; Wells were coated with 100 &#956;L of diluted capture antibody per well and incubated overnight at 4 &#176;C&#46; Wells were aspirated and washed 5 times&#46; Then&#44; wells were blocked with 200 &#956;L of assay diluents and incubated for 1 h at room temperature&#46; After intensive washing&#44; 100 &#956;L of sample or standard were added to each well and incubated for 2 h at room temperature&#59; followed by washing and secondary antibody incubation &#40;100 &#956;L&#41; for 1 h at room temperature&#46; After washing&#44; 100 &#956;L of diluted SAv-HRP were added to each well for detection and incubated for 30 min at room temperature&#46; TMB substrate solution &#40;Sigma-Aldrich&#44; USA&#41; was added to each well and incubated for 30 min in the dark&#46; An absorban-ce microplate reader &#40;ELx800 BioTek&#41; and Gen5 v&#46;1&#46;07&#46;5 software were used to read at 450 nm with &#955; correction 570 nm&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Histopathological and morphometric analysis</span><p id="p0145" class="elsevierStylePara elsevierViewall">Liver tissue fragments were fixed in 10&#37; formaldehyde solution&#44; dissolved in phosphate-saline buffer &#40;pH 7&#46;4&#41;&#44; dehydrated in alcohol and embedded in paraffin&#46; Four-micrometer paraffin sections were stained with hematoxylin and eosin &#40;HE&#41; or Masson trichromic &#40;MT&#41; and subjected to histopathological examination&#46;</p><p id="p0150" class="elsevierStylePara elsevierViewall">Fibrosis was scored under light microscopy following the criteria reported elsewhere&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a><ul class="elsevierStyleList" id="li0020"><li class="elsevierStyleListItem" id="list0065"><span class="elsevierStyleLabel">&#8226;</span><p id="p0155" class="elsevierStylePara elsevierViewall">Grade 0 is normal&#46;</p></li><li class="elsevierStyleListItem" id="list0070"><span class="elsevierStyleLabel">&#8226;</span><p id="p0160" class="elsevierStylePara elsevierViewall">Grade I stands for light fibrosis&#58; collagen fibers extend from the portal triad or central vein to the peripheral region&#46;</p></li><li class="elsevierStyleListItem" id="list0075"><span class="elsevierStyleLabel">&#8226;</span><p id="p0165" class="elsevierStylePara elsevierViewall">Grade II is mild fibrosis&#58; mild collagen fibers with extension are present&#44; but there is no nodules formation&#46;</p></li><li class="elsevierStyleListItem" id="list0080"><span class="elsevierStyleLabel">&#8226;</span><p id="p0170" class="elsevierStylePara elsevierViewall">Grade III is moderate fibrosis&#58; collagen fibers form incomplete nodules&#46;</p></li><li class="elsevierStyleListItem" id="list0085"><span class="elsevierStyleLabel">&#8226;</span><p id="p0175" class="elsevierStylePara elsevierViewall">Grade IV is severe fibrosis&#58; well constituted nodules limited by collagen fibers&#46;</p></li></ul></p><p id="p0180" class="elsevierStylePara elsevierViewall">Each sample was observed at x 20 magnification and every specimen analyzed contained a centrilobu-lar vein&#46; The degree of fibrosis was expressed as the mean of 10 different fields in each slide&#46; In order to quantify fibrosis&#44; we also performed automated mor-phometric analysis to determine the percentage of fi-brosis&#46; A JVC TK-C1380 camera was used to digitalize and analyze the MT sections&#44; studying 4080 random selected fields at x 20 magnification&#46; We calculated peri-hepatocellular and luminal fibrosis using the following formula&#58;<elsevierMultimedia ident="FD1"></elsevierMultimedia></p><p id="p0185" class="elsevierStylePara elsevierViewall">Measured using Leica QWin Standard v2&#46;2 software&#46;</p><p id="p0190" class="elsevierStylePara elsevierViewall">Another morphometric analysis was undertaken to determine the percentage of normal hepatocytes and changes related to regeneration &#40;binucleation&#41;&#44; apoptosis &#40;condensed nuclei with well preserved cytoplasm&#41; and necrosis &#40;nuclei fragmentation with cytoplasm dissolution&#41;&#46; Images from each HE stain were digitalized &#40;JVC TK-C1380&#41; at x 100 magnification&#46; 200 cells were randomly selected using the Leica QWin Standard v2&#46;2 program and the formula&#58;<elsevierMultimedia ident="FD2"></elsevierMultimedia></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Statistical analysis</span><p id="p0195" class="elsevierStylePara elsevierViewall">Data are reported as means &#177; standard deviation of three independent experiments conducted in quadruplicate&#46; Statistical analysis was performed using a non parametric ANOVA&#46; Group differences were analyzed using Tukey&#8217;s test&#46; Significant differences were established at p &#60; 0&#46;05&#46; The results were analyzed by SPSS 15&#46;0 software&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Results</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Evaluation of biochemical parameters</span><p id="p0200" class="elsevierStylePara elsevierViewall">An analysis of serum ALT&#44; AST&#44; &#947;-GT and ALP activity was carried out to evaluate the amount of liver injury&#46; After 30 days&#44; the group of liver damaged showed significantly higher levels of ALT&#44; AST and &#947;-GT than those of the control &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#41;&#46; No significant differences were observed in ALT&#44; AST and &#947;-GT levels between the liver damaged group and the liver damaged &#43; THF group after 30 days&#46; No significant differences in ALP levels were detected in any group after 30 days&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0205" class="elsevierStylePara elsevierViewall">After 60 days&#44; ALT&#44; AST&#44; &#947;-GT and ALP levels were significantly higher in the liver damaged group than in the control &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#41;&#46; THF administration significantly decreased the serum levels of ALT and AST in rats with PS-induced liver damage &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#41;&#46; No significant &#947;-GT and ALP level changes were observed in the groups with liver damage and THF-treated liver damage&#46;</p><p id="p0210" class="elsevierStylePara elsevierViewall">After 90 days&#44; there was a slight increase in ALT and AST levels in the liver damaged group in comparison with the control group&#46; However&#44; &#947;-GT and ALP levels had significantly increased in the first group when compared with the control &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#41;&#46; No significant difference was found between the liver damaged group and the THF-treated liver damaged group&#46;</p><p id="p0215" class="elsevierStylePara elsevierViewall">There was no significant difference in ALT&#44; AST&#44; &#947;-GT and ALP levels between THF-treated groups and the control group after 30&#44; 60 and 90 days&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Effect of THF on serum IL-6 and IL-10 levels</span><p id="p0220" class="elsevierStylePara elsevierViewall">Pro-inflammatory cytokines have been shown to be critical mediators in hepatocellular injury&#46; We measured serum IL-6 levels given that it is one of the major pro-inflammatory cytokines&#44; and also determined IL-10 levels considering it is an anti-inflammatory cytokine&#46;</p><p id="p0225" class="elsevierStylePara elsevierViewall">The liver damaged group showed an increase in both IL-6 and IL-10 serum levels &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2A</a>&#41; when compared with the control after 30 days&#46; THF treatment in animals with PS-induced liver damage showed a significant reduction in the serum levels of both cytokines when compared with the liver damaged group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2A</a>&#41;&#59; IL-6 levels&#44; however&#44; did not reach those of the control group&#46; By itself&#44; THF resulted in an increase in the serum levels of both cytokines when compared with the control &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2A</a>&#41;&#46;</p><elsevierMultimedia ident="f0010"></elsevierMultimedia><p id="p0230" class="elsevierStylePara elsevierViewall">After 60 days&#44; the liver damaged group showed very high levels of IL-6 and IL-10 when compared with the control &#40;p &#60; 0&#46;05&#44; <a class="elsevierStyleCrossRef" href="#f0010">Figure 2B</a>&#41;&#46; THF induced a significant reduction of IL-6 and IL-10 in animals with liver damage when compared with the PS-induced liver damaged group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2B</a>&#41;&#46; Rats treated exclusively with THF showed no significant change in IL-6 and IL-10 levels when compared with the control&#46;</p><p id="p0235" class="elsevierStylePara elsevierViewall">After 90 days&#44; there was a significant increase in IL-10 levels in the liver damaged group when compared with control group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2C</a>&#41;&#46; THF treatment of rats with liver damage produced a significant reduction in IL-10 when compared with the liver damaged group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">Figure 2C</a>&#41;&#46; No differences in the IL-6 and IL-10 serum levels of the THF and control groups were observed&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Histopathological findings</span><p id="p0240" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#f0015">Figures 3</a> and <a class="elsevierStyleCrossRef" href="#f0020">4</a> show representative histological changes in the livers of the different groups&#46; By day 30&#44; the animals that received PS showed mild mono-nuclear inflammatory infiltrate in the portal areas with scarce hepatocyte damage and lack of evident fibrosis &#40;<a class="elsevierStyleCrossRef" href="#f0015">Figure 3C</a>&#41;&#46; Sections from animals with PS-induced liver damage and treated with THF did not show significant differences when compared to the liver damaged group &#40;<a class="elsevierStyleCrossRef" href="#f0015">Figure 3D</a>&#41;&#46; By day 60&#44; animals with PS-induced liver damage showed intense chronic inflammatory infiltrate in portal areas with proliferation of biliary ducts&#59; scattered necrotic and regenerative hepatocytes were also seen &#40;<a class="elsevierStyleCrossRef" href="#f0015">Figure 3E</a>&#41;&#46; MT stains showed variable size nodules limited by thick fibrotic trabecula &#40;<a class="elsevierStyleCrossRef" href="#f0020">Figure 4E</a>&#41;&#46; Rats treated with liver damaged and treated with THF showed a striking reduction of inflammation&#44; hepatocytes damage and fibrosis&#44; but this varied among the animals&#46; Four of the six rats examined showed evident improvement while in the other two did not &#40;<a class="elsevierStyleCrossRef" href="#f0015">Figure 3F</a> and <a class="elsevierStyleCrossRef" href="#f0020">4F</a>&#41;&#46; After 90 days&#44; the liver damaged group and the liver damaged group treated with THF showed scattered nodules limited by collagen fibers&#44; mild chronic inflammation in portal areas with numerous biliary ducts and hepatocytes damage and regeneration expressed in binucleation &#40;<a class="elsevierStyleCrossRef" href="#f0015">Figure 3G-3H</a> and <a class="elsevierStyleCrossRef" href="#f0020">4G-4H</a>&#41;&#46; No evident histological abnormalities were seen in the liver of animals treated with THF &#40;<a class="elsevierStyleCrossRef" href="#f0015">Fig 3B</a> and <a class="elsevierStyleCrossRef" href="#f0020">4B</a>&#41;&#46; Grades of fibrosis are reported in <a class="elsevierStyleCrossRef" href="#t0010">table 2</a>&#46;</p><elsevierMultimedia ident="f0015"></elsevierMultimedia><elsevierMultimedia ident="f0020"></elsevierMultimedia><elsevierMultimedia ident="t0010"></elsevierMultimedia><p id="p0245" class="elsevierStylePara elsevierViewall">There was a good correlation between the morphological &#40;<a class="elsevierStyleCrossRef" href="#f0020">Figure 4</a>&#41; and morphometrical &#40;<a class="elsevierStyleCrossRef" href="#t0015">Table 3</a>&#41; analysis&#46; Liver fibrosis was observed 60 days after PS administration&#44; showing a 200-fold increase when compared with the control group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0015">Table 3</a>&#41;&#46; Animals with PS-induced liver damage and treated with THF showed an important reduction in fibrosis &#40;59&#37;&#41; after 60 days when compared with the liver damaged group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0015">Table 3</a>&#41;&#46; After 90 days&#44; fibrosis had decreased and there was no difference between PS liver damage and animals with liver damage treated with THF &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#t0015">Table 3</a>&#41;&#46; There was no fibrosis in the THF groups after 30&#44; 60 and 90 days &#40;<a class="elsevierStyleCrossRef" href="#t0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="t0015"></elsevierMultimedia><p id="p0250" class="elsevierStylePara elsevierViewall">Individual hepatocytes analysis was performed to determine the percentage of normal&#44; regenerative&#44; apoptotic and necrotic hepatocytes according to morphological criteria&#46; After 30 days&#44; the liver damaged group had a decrease in &#37; of normal hepatocytes&#44; and an increase in the &#37; of regenerative&#44; apoptotic and necrotic hepatocytes when compared with the control &#40;p &#60; 0&#46;05&#41;&#46; The liver damaged&#44; THF-treated group showed a reduction in the &#37; of cell regeneration when compared with the liver damaged group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0025">Figure 5A</a>&#41;&#46;</p><elsevierMultimedia ident="f0025"></elsevierMultimedia><p id="p0255" class="elsevierStylePara elsevierViewall">After 60 days&#44; the liver damaged group showed a decrease in &#37; of normal hepatocytes and a &#37; increase in regenerative&#44; apoptotic and necrotic hepato-cytes when compared to the control &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0025">Figure 5B</a>&#41;&#46; The THF-treated liver damaged group showed an increase in &#37; of normal hepatocytes and a lesser &#37; of apoptotic and necrotic cells than those observed in the liver damaged group &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0025">Figure 5B</a>&#41;&#46;</p><p id="p0260" class="elsevierStylePara elsevierViewall">After 90 days&#44; normal cells continued to be at a low level and the &#37; of regenerative and apoptotic he-patocytes had increased in the liver damaged group when compared with the control &#40;p &#60; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0025">Figure 5C</a>&#41;&#46; There was no difference between the liver damaged and the liver damaged and THF-treated groups&#46;</p><p id="p0265" class="elsevierStylePara elsevierViewall">No differences were observed between the THF group and the control group after 30&#44; 60 and 90 days&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="p0270" class="elsevierStylePara elsevierViewall">In the past decade there have been significant advances in the design of new antifibrotic agents&#44; mostly due to an improved understanding of the cellular and molecular mechanisms associated with the development of liver cirrhosis&#46; But only a few agents have reached the clinical trial phase and a complete and successful pharmacological treatment for liver cirrhosis is not yet available&#46; Here we examined the effect of THF in hepatic fibrosis during different stages of development using an immunologically-induced liver fibrosis model&#46;</p><p id="p0275" class="elsevierStylePara elsevierViewall">Most hepatic fibrosis models&#44; such as thioaceta-mide&#44; carbon tetrachloride &#40;CCl<span class="elsevierStyleInf">4</span>&#41; and bile-duct liga-tion&#44; are established by inducing so-called post-necrotic hepatic fibrosis&#46; PS-induced hepatic fibrosis is mainly the product of intense immune responses characterized by slight hepatic damage and a slow development of fibrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> The histopathologi-cal changes of this model are characterized by mononuclear cell infiltration and a fibrotic response that mostly takes place in the periportal area&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="p0280" class="elsevierStylePara elsevierViewall">It has been reported that&#44; in a PS-induced liver damage model&#44; fibrosis is produced after 60 days of PS administration in Wistar rats&#46; We studied the inflammatory process during stages of early liver damage and prior to the development of fibrosis &#40;30 days&#41;&#44; as well as during post-chronic damage and liver fibrosis stages &#40;90 days&#41;&#46;</p><p id="p0285" class="elsevierStylePara elsevierViewall">ALT and AST enzymatic levels were measured in conjunction&#44; given that they are indicative of liver damage&#46; ALT and AST levels increased after 30 to 60 days in rats receiving PS&#46; These increments were not as high as those observed in other models but were statistically significant when compared with the control group&#46; Therefore&#44; the current results indicate the presence of hepatocellular damage and disease progression&#44; which is in agreement with other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> THF-treated animals with PS-induced liver damage showed a reduction in ALT and AST levels&#44; showing the positive effect of THF on a damaged liver&#46; Few studies have documented PS-induced liver injury and fibrosis after 60 days&#44; showing low or null increase in enzymatic levels&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Likewise&#44; we did not observe any changes in the ALT or AST levels of animals with PS-induced liver fibrosis after 90 days&#44; which suggests spontaneous resolution after 60 or more days&#44; as in the case of other immunological models such as the collagen-induced arthritis one&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Indeed&#44; the liver damaged&#44; THF-treated group showed no changes after 90 days&#44; probably as a consequence of spontaneous re-solution&#46;</p><p id="p0290" class="elsevierStylePara elsevierViewall">It has been suggested that this model is autoimmune because of the deposition of gammaglobulins and immune complexes&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> which is similar to the bile duct and portal tract damage observed in human autoimmune hepatitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> For this reason&#44; we evaluated &#947;-GT and ALP levels&#44; as these enzymes are indicative of hepatocyte damage and bile duct in-jury&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> &#947;-GT levels increased after 30 days and remained high until day 90&#44; whereas ALP levels increased after 60 and 90 days in animals with liver damage and fibrosis&#46; These results suggest that he-patocyte and bile duct damage progressively increases after PS administration&#46; THF treatment did not alter high ALP and &#947;-GT levels&#44; suggesting that&#44; while THF might reduce &#40;30 days&#41; or prevent &#40;60 days&#41; hepatocytes damage&#59; it cannot prevent bile duct or portal tract damage in this model&#46;</p><p id="p0295" class="elsevierStylePara elsevierViewall">We observed significant abnormalities in the his-tological study that satisfactorily correlated with enzyme levels during days 30 and 60&#46; We found an increase in the portal tracts area due to extensive inflammatory cell infiltration and striking bile duct proliferation&#46; THF treatment reduced the inflammatory cell infiltration in portal tracts in the time points observed&#46; It has been previously reported that THF may modify IL-2 levels<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and that this cytokine acts as an anti-inflammatory by modulating IL-1&#44; a potent inflammatory cytokine that increases inflammatory response&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> The changes in inflammatory response and the alterations in liver architecture could be due to the fact that THF treatment is modulating the immune response to a certain degree&#46;</p><p id="p0300" class="elsevierStylePara elsevierViewall">After 30 days of PS administration&#44; morphometric evaluation showed an increase in necrotic and apop-totic cells&#44; but not as high as those observed in other post-necrotic models&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> It has been observed that&#44; by itself&#44; PS does not produce hepatocytes damage but induces changes in the micro-environment&#44; affecting their functioning&#46; Autoimmune hepatitis is characterized by a release of pro-inflammatory cytokines &#40;like TNF-&#945;&#44; IL-1 or IL-6&#41;&#44; which leads hepatocytes to apoptosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">32</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> Necrosis has also been associated to intense autoimmune responses&#59; patients with high auto-reactivity show elevated percentages of centrilobular necrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> After 60 days of liver damage due to PS administration&#44; we observed a higher percentage of apoptotic and necrotic hepatocytes than on day 30&#46; Those changes correlated with increased ALT and AST levels&#46; THF treatment reduced the percentage of necrotic and apoptotic hepatocytes&#44; particularly after 60 days&#46; Moreover&#44; fibrosis was also decreased by THF treatment&#44; suggesting that it might improve the inflammatory and immunological micro-environment in the liver&#46;</p><p id="p0305" class="elsevierStylePara elsevierViewall">After 30 and 60 days&#44; rats with liver damage showed a higher increase in serum IL-6 levels&#46; It is well known that IL-6 is a pro-inflammatory cytokine that participates in the inflammatory response&#44; but it also plays a key role in matrix extracellular production by regulating the activity of MMP-13 and TIMP-1&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> Moreover&#44; IL-6 is also a cytotoxic cytokine released by Kupffer cells and is considered to be one of the mediators that stimulate target cells &#40;inflammatory cells&#44; hepatocytes&#44; epithelial cells and HSC&#41; at the beginning of the liver damage pro-cess&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> This study found that liver-damaged rats showed an increase in serum IL-6 levels with progressive inflammation and liver fibrosis after 30 and 60 days&#46; After 90 days&#44; rats treated with PS showed normal IL-6 levels&#44; which suggest the spontaneous resolution of the inflammatory&#47;immune response&#46;</p><p id="p0310" class="elsevierStylePara elsevierViewall">Animals with liver damage treated with THF showed a reduction in serum IL-6 levels along with a decrease in the inflammatory response at 30 and 60 days of THF treatment&#46; Human liver myofibro-blasts can produce IL-6<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> and this cytokine induced the proliferation of quiescent HSCs&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> By decreasing IL-6 production <span class="elsevierStyleItalic">in vivo&#44;</span> THF might reduce the rate of HSC proliferation and activation&#44; thus decreasing liver fibrosis&#46; By itself&#44; THF was able to induce production of IL-6 at 30 days&#44; but no alterations in liver function and morphology were found&#44; indicating that THF alone does not induce liver damage&#46; However there are no reports in the literature of THF producing damage&#44; and the increase of IL-6 &#40;and IL-10&#41; suggest an inflammatory process&#46; More experiments need to be performed in order to clarify this observation&#46;</p><p id="p0315" class="elsevierStylePara elsevierViewall">The reduction of the inflammatory response observed in THF-treated animals with liver damage and fibrosis suggests an anti-inflammatory response&#46; IL-10 has been reported to have anti-inflammatory effects in some liver diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> We observed that THF increased IL-10 levels in the liver damaged group after 30 days&#46; This could be explained for the increase of IL-6 levels&#44; observed in this group of liver damage after 30 days&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> As mentioned above&#44; more experiments&#44; including evaluation in other tissues and blood parameters need to be performed in order to understand this observation&#46; After 60 days&#44; serum IL-10 levels showed a striking increase in the THF-treated liver damaged group&#44; probably in response to higher IL-6 levels&#46; After 90 days we observed higher IL-10 levels in the liver damaged group&#44; along with low IL-6 levels&#46; In fact&#44; several studies have reported the role of IL-10 as a protective cyto-kine working against hepatic injury in diseases such as diet-induced insulin resistance in liver&#59; hepatitis C virus infection&#44; and fatty liver disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">45</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">47</span></a> In this model&#44; THF may be acting having an effect on CD4<span class="elsevierStyleSup">&#43;</span>CD25<span class="elsevierStyleSup">&#43;</span>FoxP3<span class="elsevierStyleSup">&#43;</span> T<span class="elsevierStyleInf">reg</span> cells&#44; a subtype that regulates autoimmune&#47;inflammatory process&#44; like the one in this model&#44; via IL-10 production&#46; Other thymus extracts&#44; like thymic stromal lymphopoietin&#44; are able to induce the generation of FoxP3<span class="elsevierStyleSup">&#43;</span> regulatory T cells by activating plasmoacytoid dentritic cells&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> THF could be inducing a Th1 cytokines&#44; like IL-10&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">49</span></a> and suppressing Th2&#44; like IL-6&#46; This effect has been reported in other thymus extracts&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusion</span><p id="p0320" class="elsevierStylePara elsevierViewall">Our findings suggest that THF effectively reduced the development of liver fibrosis in a model of PS-induced liver fibrosis in rats&#46; The mechanism might be associated to THF-induced IL-6 down-regulation&#44; probably by induction of CD4<span class="elsevierStyleSup">&#43;</span>CD25<span class="elsevierStyleSup">&#43;</span>FoxP3<span class="elsevierStyleSup">&#43;</span> T<span class="elsevierStyleInf">reg</span> cells or dendritic cells&#44; which suppresses inflammatory response and&#44; presumably&#44; reduces the activation of HSCs&#46; Although more experiments are needed in order to understand the effect and security of THF&#44; these results suggest that THF could be considered a new class of potential anti-hepatic fibrosis drug&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Abbreviations</span><p id="p0325" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="li0025"><li class="elsevierStyleListItem" id="list0090"><span class="elsevierStyleLabel">&#8226;</span><p id="p0330" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">HSC&#58;</span> Hepatic stellate cell&#46;</p></li><li class="elsevierStyleListItem" id="list0095"><span class="elsevierStyleLabel">&#8226;</span><p id="p0335" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">TGF-&#946;&#58;</span> Transforming growth factor-beta&#46;</p></li><li class="elsevierStyleListItem" id="list0100"><span class="elsevierStyleLabel">&#8226;</span><p id="p0340" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">IL-6&#58;</span> Interleukin 6&#46;</p></li><li class="elsevierStyleListItem" id="list0105"><span class="elsevierStyleLabel">&#8226;</span><p id="p0345" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">PS&#58;</span> Porcine serum&#46;</p></li><li class="elsevierStyleListItem" id="list0110"><span class="elsevierStyleLabel">&#8226;</span><p id="p0350" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">THF&#58;</span> Thymic humoral factor&#46;</p></li><li class="elsevierStyleListItem" id="list0115"><span class="elsevierStyleLabel">&#8226;</span><p id="p0355" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">ALT&#58;</span> Alanine aminotransferase&#46;</p></li><li class="elsevierStyleListItem" id="list0120"><span class="elsevierStyleLabel">&#8226;</span><p id="p0360" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">AST&#58;</span> Aspartate aminotransferase&#46;</p></li><li class="elsevierStyleListItem" id="list0125"><span class="elsevierStyleLabel">&#8226;</span><p id="p0365" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">ALP&#58;</span> Alkaline phosphatase&#46;</p></li><li class="elsevierStyleListItem" id="list0130"><span class="elsevierStyleLabel">&#8226;</span><p id="p0370" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">&#947;-GT&#58;</span> Gamma-glutamyltransferase&#46;</p></li><li class="elsevierStyleListItem" id="list0135"><span class="elsevierStyleLabel">&#8226;</span><p id="p0375" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">IL-10&#58;</span> Interleukin 10&#46;</p></li><li class="elsevierStyleListItem" id="list0140"><span class="elsevierStyleLabel">&#8226;</span><p id="p0380" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">ip&#58;</span> Intraperitoneal&#46;</p></li></ul></p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Acknowledgment</span><p id="p0385" class="elsevierStylePara elsevierViewall">The authors wish to express their gratitude to Patricia Toledo Sanchez for her help with the histo-logical work&#46;</p><p id="p0390" class="elsevierStylePara elsevierViewall">&#176;The authors wish to express their gratitude to CONACYT &#40;scholarship 205215&#41; and UAS &#40;DGIP scholarship for Doctores Jovenes&#41; for supporting the studies of Lorenzo Ulises Osuna Mart&#237;nez&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xres1209585"
          "titulo" => "Abstract"
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            0 => array:1 [
              "identificador" => "abs0005"
            ]
          ]
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        1 => array:2 [
          "identificador" => "xpalclavsec1126214"
          "titulo" => "Key words"
        ]
        2 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        3 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Objective"
        ]
        4 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Materials and Methods"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Reagents and animals"
            ]
            1 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Animal model"
            ]
            2 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Pharmacological treatments and sample collection"
            ]
            3 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Biochemical analysis in serum"
            ]
            4 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Quantification of IL-6 and IL-10 in serum"
            ]
            5 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Histopathological and morphometric analysis"
            ]
            6 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Statistical analysis"
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          ]
        ]
        5 => array:3 [
          "identificador" => "sec0055"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Evaluation of biochemical parameters"
            ]
            1 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Effect of THF on serum IL-6 and IL-10 levels"
            ]
            2 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Histopathological findings"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Discussion"
        ]
        7 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conclusion"
        ]
        8 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Abbreviations"
        ]
        9 => array:2 [
          "identificador" => "sec0090"
          "titulo" => "Acknowledgment"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2011-03-14"
    "fechaAceptado" => "2011-07-25"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec1126214"
          "palabras" => array:6 [
            0 => "Hepatitis"
            1 => "IL-6"
            2 => "IL-10"
            3 => "Autoimmune"
            4 => "THF"
            5 => "Fibrosis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abs0005" class="elsevierStyleSection elsevierViewall"><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introduction&#46;</span> Immunomodulatory drugs have been reported to have anti-inflammatory and anti-fibrotic properties&#46; Thymic Humoral Factor &#40;THF&#41;&#44; a peptide produced in the thymus&#44; causes a potent immunomodulatory effect on different components of the immune system&#46; <span class="elsevierStyleBold">Objective&#46;</span> To evaluate the effect of THF on different stages of liver damage and fibrosis induced in rats through the administration of porcine serum &#40;PS&#41;&#46;</p><p id="sp1045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Material and methods&#46;</span> PS-induced liver fibrosis models serve as a primarily immunological mechanism in the development of liver damage and fibrosis&#46;</p><p id="sp1050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results&#46;</span> The intraperitoneal administration of THF in rats with PS-induced liver damage produced a reduction of ALT and AST after 60 days&#46; Histopathological changes in liver sections showed an improved histological appearance and lower &#37; of fibrosis after 60 days in liver damaged rats that received THF treatment&#46; Serum IL-6 levels were visibly reduced by THF administration after 60 days and in comparison with rats that did not receive the treatment&#46; This was due to an increment in serum IL-10 levels caused by the administration of THF&#44; which appears to reduce the inflammatory process by decreasing immune response&#46;</p><p id="sp1055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion&#46;</span> THF had beneficial effects in combating liver damage and fibrosis processes in an autoimmune model of PS-induced liver fibrosis in rats&#46;</p></span>"
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      0 => array:7 [
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        "etiqueta" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 1</span></span>"
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          "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Protocol for experimental groups&#58; 1&#46; Control&#58; rats received 0&#46;5 mL of the vehicle saline solution via ip injection twice per week&#46; 2&#46; THF&#58; rats were treated with THF 50 ng&#47;kg three times per week via ip injection&#46; 3&#46; LD &#40;liver damaged&#41;&#58; animals received PS 3&#46;5 mL&#47;kg twice per week via ip injection&#59; and 4&#46; LD treated with THF&#58; animals were treated with PS &#40;3&#46;5 mL&#47;kg twice per week&#41; and THF &#40;50 ng&#47;kg three times per week&#41;&#46;</p>"
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      1 => array:7 [
        "identificador" => "f0010"
        "etiqueta" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 2</span></span>"
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          "en" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Effect of THF on serum IL-6 and IL-10 levels&#46; Serum levels for groups at 30&#44; 60 and 90 of&#58; A&#46; IL-6&#46; B&#46; IL-10&#46; The results are presented as mean &#177; S&#46;D&#46; from 6 animals in each group&#46; <span class="elsevierStyleSup">a</span> p &#60; 0&#46;05 compared with the control at 30 days&#46; <span class="elsevierStyleSup">b</span> p &#60; 0&#46;05 compared with the THF at 30 days&#46; <span class="elsevierStyleSup">c</span> p &#60; 0&#46;05 compared with LD &#40;liver damaged&#41; at 30 days&#46; <span class="elsevierStyleSup">d</span> p &#60; 0&#46;05 compared with the control at 60 days&#46; <span class="elsevierStyleSup">e</span> p &#60; 0&#46;05 compared with the THF at 60 days&#46; <span class="elsevierStyleSup">f</span> p &#60; 0&#46;05 compared with LD at 60 days&#46; <span class="elsevierStyleSup">g</span> p &#60; 0&#46;05 compared with the control at 90 days&#46; <span class="elsevierStyleSup">h</span> p &#60; 0&#46;05 compared with the THF at 90 days&#46; <span class="elsevierStyleSup">i</span> p &#60; 0&#46;05 compared with LD at 90 days&#46;</p>"
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        "identificador" => "f0015"
        "etiqueta" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 3</span></span>"
        "tipo" => "MULTIMEDIAFIGURA"
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          "en" => "<p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Effect of THF on liver histopathology&#46; Liver slice&#58; A&#46; Control&#46; B&#46; THF&#46; C&#46; LD &#40;liver damaged&#41; after 30 days&#46; D&#46; LD &#43; THF after 30 days&#46; E&#46; LD after 60 days&#46; F&#46; LD &#43; THF after 60 days&#46; G&#46; LD after 90 days&#46; H&#46; LD &#43; THF after 90 days&#46; Hematoxylin and Eosin staining&#44; magnification x 20&#46;</p>"
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        "etiqueta" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 4</span></span>"
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          "en" => "<p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Effect of THF on liver fibrosis&#46; Liver slice&#58; A&#46; Control&#46; B&#46; THF&#46; C&#46; LD &#40;liver damaged&#41; after 30 days&#46; D&#46; LD &#43; THF after 30 days&#46; E&#46; LD after 60 days&#46; F&#46; LD &#43; THF after 60 days&#46; G&#46; LD after 90 days&#46; H&#46; LD &#43; THF after 90 days&#46; Masson&#8217;s tri-chrome staining&#44; magnification x10&#46;</p>"
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      4 => array:7 [
        "identificador" => "f0025"
        "etiqueta" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 5</span></span>"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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          "en" => "<p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Effect of THF on hepatocyte status&#46; &#37; of normal&#44; normal in regeneration&#44; apoptotic and necrotic hepatocytes for groups in&#58; A&#46; 30 days&#46; B&#46; 60 days&#46; C&#46; 90 days&#46; The results are presented as mean &#177; S&#46;D&#46; from 6 animals in each group&#46; <span class="elsevierStyleSup">a</span> p &#60; 0&#46;05 compared with the control in its respective days&#46; <span class="elsevierStyleSup">b</span> p &#60; 0&#46;05 compared with THF in its respective days&#46; <span class="elsevierStyleSup">c</span> p &#60; 0&#46;05 compared with LD &#40;liver damaged&#41; in its respective days&#46;</p>"
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          "leyenda" => "<p id="npara0005" class="elsevierStyleSimplePara elsevierViewall">Values are presented as mean &#177; S&#46;D&#46; from 6 animals in each group&#46;</p>"
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                  \t\t\t\t  " align="center" valign="middle" scope="col">ALP &#40;U&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="middle">&#8226; 30 days&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">54&#46;2 &#177; 3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">81&#46;5 &#177;6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">1&#46;8 &#177; 0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">127&#46;7 &#177; 9&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">53&#46;1 &#177; 3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">85&#46;7 &#177; 6&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">1&#46;6 &#177; 0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">115&#46;9 &#177; 10&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">70&#46;4 &#177; 8&#46;6<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">103&#46;9 &#177; 10&#46;7<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">5&#46;5 &#177; 0&#46;9<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">126&#46;9 &#177; 10&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD &#43; THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">64&#46;9 &#177; 4&#46;4<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">101&#46;8 &#177; 5&#46;9<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">4&#46;8 &#177; 1&#46;2<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">124 &#177; 10&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&#8226; 60 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">54&#46;6 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">73&#46;3 &#177; 9&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">3&#46;2 &#177; 1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">135&#46;1 &#177; 20&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">67&#46;8 &#177; 11&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">78&#46;7 &#177; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">4&#46;6 &#177; 1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">150&#46;1 &#177; 20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">138&#46;6 &#177; 54&#46;3<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">160&#46;6 &#177; 25&#46;6<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">14&#46;3 &#177; 1&#46;1<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">375&#46;4 &#177; 68&#46;1<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD &#43; THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">70&#46;3 &#177; 12&#46;2<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">96&#46;9 &#177; 17&#46;7<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">12&#46;2 &#177; 1&#46;8<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">370&#46;5 &#177; 14&#46;1<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&#8226; 90 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">54&#46;9 &#177; 10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">74&#46;6 &#177; 7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">2&#46;2 &#177; 0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">139 &#177; 13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">57&#46;2 &#177; 8&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">70&#46;2 &#177; 11&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">2&#46;8 &#177; 0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">146&#46;2 &#177; 21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">86&#46;1 &#177; 10&#46;3<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">107&#46;7 &#177; 20&#46;5<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">16&#46;9 &#177; 3&#46;2<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">362&#46;7 &#177; 65&#46;1<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD &#43; THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">74&#46;9 &#177; 15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">95&#46;5 &#177; 20&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">16&#46;2 &#177; 2&#46;4<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">285&#46;2 &#177; 73&#46;4<a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#t1fn1"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2065059.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "t1fn1"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npara0225">p &#60; 0&#46;05 compared with the control group in its respective days&#46; <span class="elsevierStyleSup">&#8224;</span>p &#60; 0&#46;05 compared with the THF group in its respective days&#46; <span class="elsevierStyleSup">&#8225;</span> p &#60; 0&#46;05 compared with the LD &#40;liver damaged&#41; group in its respective days&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">Effect of THF on serum levels of ALT&#44; AST&#44; &#947;-GT and ALP after 30&#44; 60 or 90 days of evaluation&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "t0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="npara0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">LD&#58;</span> Liver damaged&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="5" align="center" valign="middle" scope="col">Degree of hepatic fibrosis</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="middle" scope="col">O&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="middle" scope="col">I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="middle" scope="col">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="middle" scope="col">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="middle" scope="col">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&#8226; 30 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD &#43; THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&#8226; 60 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD &#43; THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&#8226; 90 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">LD &#43; THF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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Article information
ISSN: 16652681
Original language: English
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