**7. References**

368 Hepatocellular Carcinoma – Basic Research

removed oxidized pyrimidines induced by NDBA and BaP and oxidized purines induced by NDMA, NPYR, NPIP, MeIQx, diMeIQx and PhIP. This may be due to the antioxidant property of GA (Gali et al., 1992). Phenolic hydroxyl groups are known to be potent in scavenging free radicals and the OH group at the para position to the carboxylic group is especially effectual for the antioxidant activity (Son and Lewis, 2002). Thus the three hydroxyl groups present in GA may be responsible for its antioxidant activity. Although, Lu et al (2006) showed that the protective effect of GA derivatives seemed to depend more

Our results also showed that DNA strand breaks induced by NDMA, NPYR, BaP and PhIP were reduced by PCA. In addition, PCA also removed the oxidized pyrimidines induced by NDMA, NPYR, NPIP, BaP and PhIP and the oxidized purines induced by NDMA, NPYR, NDBA, NPIP, MeIQx and diMeIQx. Supporting that, an additional hydroxyl group in the chemical structure of the PCA would significantly affect the biological activity against the mutagen. Shahidi and Wanasundara (1992) and Makena and Chung (2007) reported that the position and number of hydroxyl groups are crucial in the inhibitory effects of polyphenols. Moreover, it has been found that the biological activity of trans-Resveratrol (t-RES) and its analogues (PCA) significantly depends on the structural determinants, which are i) the number and position of hydroxyl groups(Wolter et al., 2002) ii) intramolecular hydrogen bonding (Fang et al., 2002), iii) stereoisomery and iv) double bond (Wright et al., 2001). Thus, the protective effect of GA and PCA against food mutagens may vary with the

structure and dose of the individual compounds and the mutagenic compound.

Taking together our results PCA was more efficient against DNA strand breaks induced by NDMA, NPYR, BaP and PhIP that GA .GA only prevent DNA strand breaks induced by BaP. Comparing the protective effect of both compounds against BaP, PCA showed higher protective effect (60-65%) than GA (18-36%). In addition PCA was also the most active against oxidized pyrimidines induced by NDMA, NPYR, NPIP, BaP and PhIP. GA only showed reduction of the oxidized pyrimidines induced by NDMA and BaP. This reduction was higher (23%, NDMA and 80-63%, BaP) than the observed by PCA against these two compounds. On the contrary, we also showed that GA and PCA at all concentrations increased oxidized purines induced by BaP. This effect could be attributed to the excess of reactive oxygen species (ROS) produced by BaP. They might cause irreparable oxidative DNA damage (Johnson and Loo, 2000). In addition, phenolic compounds have both antioxidant and prooxidant effects depending on the experimental conditions [28]. However, GA and PCA were very efficient to remove oxidized purines induced by all the mutagens tested with the exception of NDBA (GA) and PhIP (PCA). Therefore, although there is a general structure-activity relationship (López-Lázaro, 2002) that shows that some subclasses of polyphenols can be more potent antimutagens, these structural considerations can change depending on the substitution pattern of the molecule and/or the kind of

Our results indicate that, PCA was more efficient that GA to reduce DNA damage induced by food mutagens tested. PCA at the concentrations tested protect human hepatoma derived cells against DNA strand breaks induced by NDMA, NPYR, BaP and PhIP, oxidized pyrimidines induced by NDMA NPYR, NPIP, BaP, PhIP and oxidized purines induced by

on their molecular polarities rather than antioxidant activities.

compound used to induce DNA damage.

**5. Conclusion** 


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**18** 

*Hong Kong* 

**Reviews on the Epidemiology, Quality of Life,** 

**and Management of Chronic Hepatitis B (CHB)** 

Chronic hepatitis B (CHB) remains a major global health problem. About 400 million people are chronic hepatitis B carriers. CHB can affect health-related quality of life (HRQOL).

**2. Reviews on the epidemiology, Quality of Life, and management of Chronic** 

This chapter first reviews the epidemiology of hepatitis B virus (HBV) and recommended management for CHB to identify the health problems and service needs of these patients. The findings from studies on health-related quality of life (HRQOL) and CHB is highlighted to identify any knowledge gaps. Finally, available HRQOL measures are reviewed to determine which one is the most suitable for applications for the evaluation of Chinese CHB

Hepatitis B is one of the most common infectious diseases and a leading cause of death in the world (Lai, Ratziu, Yuen, & Roynard, 2003; Lavanchy, 2004, 2005; Maynard, 1990; Wright, 2006). Approximately 2 billion are infected and more than 400 million people of those are chronically infected with hepatitis B virus (HBV) (Fattovich, Bortolotti, & Donato, 2008; Lai et al., 2003). Chronically infected individuals defined as those who have diagnosed with hepatitis B surface antigen (HBsAg) for more than six months (A S Lok & McMahon, 2009; Maddrey, 2000). It was estimated that 75% of chronic hepatitis B (CHB) carriers were found in Asia and the Western Pacific regions (Gust, 1996; Maddrey, 2000; Maynard, 1990; Merican et al., 2000). HBV results in 500,000 to 1.2 million deaths per year caused by cirrhosis, liver failure or hepatocellular carcinoma (HCC) (Lavanchy, 2004, 2005). The incidence of HCC is increasing and is the fifth most common cancer worldwide killing 300,000-500,000 people per year (Lavanchy, 2004). Worldwide, approximately 30% of cirrhosis was attributable to HBV and over half (53%) of HCC was due to HBV (Perz, Armstrong, Farrington, Hutin, & Bell, 2006). HBV infection accounted for more than 50% of

Several anti-viral drugs are available for CHB patients.

**2.1.1 Epidemiology and natural history of CHB** 

**2.1 Epidemiology and management for Chronic Hepatitis B (CHB)** 

HCC (65%) and cirrhosis (57%) in Western Pacific regions (Perz et al., 2006).

**1. Introduction** 

**Hepatitis B (CHB)** 

patients in Hong Kong.

Elegance T.P. Lam and Cindy L.K. Lam

*The University of Hong Kong* 

