تأثير عامل التغذية العصبية المشتق من الخاليا النجمية المتوسطة وعدم التوازن التأكسدي في أمراض الشريان التاجي مع / بدون الكبد الدهني غير الكحولي في المرضى العراقيين

Effect of Mesencephalic Astrocyte-Derived Neurotrophic Factor and Oxidative Imbalance in Coronary Artery Diseases with/without Non-Alcoholic Fatty Liver in Iraqi Patients

Coronary artery obstructive disease is a leading cause of death worldwide in
low- and middle-income countries. It occurs at younger and older ages. Over time,
this disease doubles in adults over 30 years of age. Coronary artery disease (CAD),
also known as ischemic heart disease (IHD), refers to a group of closely associated
syndromes caused by an imbalance between the myocardial oxygen demand and
blood supply.
Non-alcoholic fatty liver disease (NAFLD) is a public health problem, affecting
up to a third of the world’s adult population. Several cohort studies have
consistently documented that NAFLD (especially in it’s more advanced forms) is
associated with a higher risk of all-cause mortality and that the leading causes of
death among patients with NAFLD are cardiovascular diseases (CVDs).
Oxidative Stress is an imbalance between the production of oxidants and
antioxidant defenses that may result in damage to biological systems. The oxidative
stress plays an essential role in the pathogenesis of chronic diseases such as
cardiovascular diseases, diabetes, neurodegenerative diseases, and cancer.
Mesencephalic astrocyte-derived neurotrophic factor (MANF) is a novel
evolutionarily conserved protein present in both vertebrate and invertebrate species.
The liver is an important metabolic organ that modulates lipid homeostasis and
multiple studies have revealed the critical role of MANF in regulating hepatic lipid
metabolism. In fact, MANF is highly abundant in the liver. The pathogenesis
of cardiovascular diseases (CVDs) is complex, with ER stress and inflammation
playing important roles. In line with other tissues or cell types, intracellular MANF
also exhibited protective functions against ER stress and inflammation in the
cardiac context, including in ischemia/reperfusion.
II
The objectives of the present projects are to know the extent to which non-alcoholic
fatty liver disease affects and its relationship to coronary artery obstructive disease,
and assessment of MANF levels and what is their impact on both NAFLD and
CAD.
The study was a case-control that included 120 samples (male and female) and
their serum samples were collected from Kerbala Heart Center/ Kerbala Health
Directorate l Kerbala – Iraq with ages ranging between 40 to 73 years. Time and
duration of study from November 2022 to May 2023. The number of patients with
coronary arteries was 60 and the number of healthy people was 60 the number of
patients with non-alcoholic fatty liver disease was 37 and 23 without NAFD. The
serum samples were withdrawn and kept at -20 °C. The Mesencephalic AstrocyteDerived Neurotrophic Factor, liver function test, lipid profile, and albumin were
determined at optimized conditions in the laboratory of the Department of
Chemistry and Biochemistry, College of Medicine, University of Kerbala by using
the Automated Biochemistry analyzer to measure liver function lipids profile and
examine albumin, while MANF biomarker was determined by ELISA Sandwich
technique.
The observed levels of MANF decreased in non-alcoholic fatty liver disease,
steatosis, and Coronary artery disease in compare with control group Results
indicated a significant difference in MANF levels among groups, and increased
levels of MDA and decreased levels in antioxidant group GPX, TAC, and Se in
CAD and NAFLD pateints. The mean levels of MANF in control was (348.62 ±
143.50) which was significantly higher than for the patient group (287.58 ± 76.71),
(p ≤ 0.001). The Distribution of serum level of MANAF, (348.62 ± 143.50), The
level of MANF protects against fatty liver and reduces chronic coronary artery
disease.
III
In Conclusions, the results presented here contribute to the determination of the
functions of the physiological MANF protein in protecting against non-alcoholic
fatty liver and chronic coronary artery obstructive disease, as decrease the level
MANF protein leads to accumulation of liver fat and also causes increased cell
death due to lack of oxygen