Στόχος της παρούσας μελέτης ήταν να μελετήσει αν το εκχύλισμα των στιγμάτων του Crocus sativus L. αναστέλλει την επαγόμενη από σεληνιώδες νάτριο ανάπτυξη καταρράκτη σε ένα in vivo πείραμα με νεογνά επίμυων του γένους Wistar. Μέθοδοι: Τα νεογνά των επίμυων κατατάχθηκαν τυχαία σε 3 ομάδες. Ομάδα Ι (ομάδα μαρτύρων) όπου χορηγήθηκε υποδόρια φυσιολογικός ορός τη 10η ημέρα της ζωής. Ομάδα ΙΙ (ομάδα σεληνιώδους νατρίου) στην οποία χορηγήθηκε υποδόρια σεληνιώδες νάτριο (20 µmol/kg σωματικού βάρους) τη 10η ημέρα της ζωής. Ομάδα ΙΙΙ (ομάδα σεληνιώδους νατρίου και εκχυλίσματος στιγμάτων Crocus sativus L.) στην οποία εκτός από το σεληνιώδες νάτριο τη 10η ημέρα της ζωής χορηγήθηκε και εκχύλισμα στιγμάτων του Crocus sativus L. (60 mg/kg σωματικού βάρους) την 9η και 12η ημέρα της ζωής. Την 21η ημέρα της ζωής οι επίμυες θυσιάστηκαν και οι κρυσταλλοειδείς φακοί απομονώθηκαν και εξετάστηκαν για την εμφάνιση καταρράκτη. Ακολούθησε προσδιορισμός στους κρυσταλλοειδείς φακούς της δραστικότητας των αντιοξειδωτικών ενζύμων δισμουτάση του σουπεροξειδίου (SOD), της υπεροξειδάσης της γλουταθειόνης (GPx) καθώς και της καταλάσης (CAT). Προσδιορίστηκαν επίσης τα επίπεδα της γλουταθειόνης στους φακούς. Επιπλέον, μετρήθηκαν τα επίπεδα της μηλονικής διαλδεΰδης (MDA), ως δείκτη υπεροξείδωσης των λιπιδίων, καθώς και η συγκέντρωση των ελεύθερων σουλφυδρυλομάδων, ως δείκτη οξειδωτικής βλάβης των πρωτεϊνών, στους κρυσταλλοειδείς φακούς των επίμυων. Η επίδραση των χορηγούμενων παραγόντων στο πρωτεϊνικό προφίλ των φακών εκτιμήθηκε μέσω προσδιορισμού του λόγου των υδατοδιαλυτών προς τις μη υδατοδιαλυτές πρωτεΐνες του φακού. Τέλος έγινε ανάλυση των υδατοδιαλυτών πρωτεϊνών με ηλεκτροφόρηση σε πήκτωμα πολυακρυλαμιδίου. Αποτελέσματα: Το εκχύλισμα αποξηραμένων στιγμάτων του Crocus sativus L. επέδειξε σημαντική προστασία έναντι στην επαγόμενη από σεληνιώδες νάτριο καταρρακτογένεση στο in vivo πειραματικό μοντέλο που χρησιμοποιήσαμε. Οι μέσες τιμές των δραστικοτήτων των αντιοξειδωτικών ενζύμων SOD, GPx, CAT καθώς και της συγκέντρωσης της γλουταθειόνης αυξήθηκαν σημαντικά στην ομάδα που έλαβε εκχύλισμα στιγμάτων του Crocus sativus L. σε σύγκριση με την ομάδα των επίμυων που δέχθηκε μόνο την τοξική δράση του σεληνιώδους νατρίου. Το εκχύλισμα των στιγμάτων του Crocus sativus L. απέτρεψε σε σημαντικό βαθμό την υπεροξείδωση των λιπιδίων καθώς και την οξειδωτική βλάβη στις πρωτεΐνες του φακού. Επίσης απέτρεψε την πρωτεόλυση των υδατοδιαλυτών πρωτεϊνών του φακού. Συμπεράσματα: Χορήγηση εκχυλίσματος αποξηραμένων στιγμάτων του Crocus sativus L. απέτρεψε την επαγόμενη από το σεληνιώδες νάτριο καταρρακτογένεση σε νεογνά επίμυων του γένους Wistar πιθανώς μέσω ενίσχυσης της αντιοξειδωτικής άμυνας του κρυσταλλοειδούς φακού, μέσω αναστολής του βαθμού της υπεροξείδωσης των λιπιδίων, μέσω προστασίας των σουλφυδρυλομάδων των πρωτεϊνών καθώς και μέσω αναστολής της πρωτεόλυσης των υδατοδιαλυτών πρωτεϊνών του φακού. Αυτά τα ευρήματα τονίζουν τις πιθανές αντικαταρρακτογενετικές δράσεις των αποξηραμένων στιγμάτων του Crocus sativus L. οι οποίες αποδίδονται στις αντιοξειδωτικές τους ιδιότητες. / The present study sought to investigate whether Crocus sativus L. stigmas extract prevents selenite-induced cataractogenesis in vivo and to study the possible protective mechanism. Methods: Wistar rat pups were randomized into 3 groups. Group I (control) received subcutaneous injection of normal saline on postnatal day 10. Groups II (selenite treated) and III (selenite and Crocus sativus L. treated) received subcutaneous injection of sodium selenite (20 µmol/kg body weight) on postnatal day 10. Group III received intraperitoneal injections of Crocus sativus L. stigmas extract (60 mg/kg body weight) on postnatal days 9 and 12. On postpartum day 21, rats were sacrificed and the lenses were isolated and examined for cataract formation. Activities of superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) and glutathione levels, as markers of antioxidant defense, were measured in the isolated lenses. Levels of the indicator of lipid peroxidation, malondialdehyde (MDA), and protein oxidation (sulfhydryl content) in lens were also determined. Effect of the different treatments on lens’ protein profile was evaluated with the estimation of soluble to insoluble protein ratio and SDS-PAGE analysis of water-soluble fraction (WSF) of lens proteins. Results: Crocus sativus L. stigmas extract demonstrated significant protection against selenite-induced cataractogenesis in vivo. The mean activities of SOD, GPx, CAT and glutathione levels were significantly increased in group III compared to the selenite-treated group. Crocus sativus L. stigmas extract significantly prevented selenite-induced lipid peroxidation, protein oxidation, as well as proteolysis and insolubilization of the lens WSF. Conclusions: Crocus sativus L. stigmas extract prevented selenite-induced cataract formation in Wistar rats possibly by reinforcement of antioxidant status, reduction of the intensity of lipid peroxidation, protection of the sulfhydryl groups, and inhibition of proteolysis of the lens WSF. These findings highlight the anti-cataractogenic potential of Crocus sativus L. stigmas by virtue of their antioxidant properties.

Abstract Carbamylation of proteins in vivo occurs by cyanate, non-enzymatically when urea is dissociated, and by myeloperoxidase-catalyzed oxidation from thiocyanate. Carbamylation of low-density lipoprotein is suggested to enhance atherogenesis in patients with with chronic kidney disease and uremia. This thesis study assessed the questions of whether healthy humans or uremic patients under enhanced carbamylation have antibodies recognizing carbamyl-epitopes in plasma, and what is their role in vivo. Also, humoral immune response to carbamyl-LDL immunization and its impact on atherogenesis in LDLR-/- mice was investigated. In this thesis study, plasma antibodies to carbamylated proteins were detected in humans, and IgG antibodies to carbamylated proteins were associated with uremia and smoking, conditions with enhanced carbamylation. The human IgG and IgM antibodies binding to carbamyl-epitopes were associated with oxidation-specific epitopes in plasma. Monoclonal Fab antibodies with characteristics of a natural antibody and ability to bind both carbamyl- and malondialdehyde-derived epitopes were cloned from healthy humans. An investigated Fab antibody was able to bind epitopes found in atherosclerotic lesions and inhibit the uptake of modified LDL by macrophages. Human plasma antibodies and the monoclonal Fab bound to epitopes found on apoptotic cells. Human B-cells secreted antibodies with similar cross-reactive binding properties between carbamyl- and malondialdehyde adducts and apoptotic cells in vitro. Immunization with mouse carbamyl-LDL without adjuvant resulted in specific IgG immune response in LDLR-/- mice, but also a cross-reaction with malondialdehyde-adducts was observed. Carbamyl-LDL immunized mice had enhanced plasma antibody binding to apoptotic cells. Carbamyl-LDL immunization did not affect atherogenesis in mice. This thesis demonstrates that IgG antibodies to carbamyl-epitope might serve as a novel indicator of carbamylation in vivo in uremic patients or smokers. The cross-reactivity between antibodies binding to carbamylated and oxidation-specific epitopes, and apoptotic cells may have a role in explaining the link between enhanced atherogenesis and kidney disease. / Tiivistelmä Proteiinien karbamylaatiota tapahtuu syanaatin vaikutuksesta. Sitä muodostuu urean hajotessa tai myeloperoksidaasin katalysoimana tiosyanaatin hapettuessa. Low-density lipoproteiinin eli LDL:n karbamylaation on esitetty edistävän valtimonkovettumataudin eli ateroskleroosin kehittymistä munuaisten vajaatoimintaa sairastavilla ureemisilla potilailla. Väitöskirjatyössä tutkittiin, onko terveillä ihmisillä ja ureemisilla potilailla karbamyyli-epitooppeja tunnistavia vasta-aineita, ja mikä niiden merkitys on elimistössä. Humoraalista immuunivastetta karbamyyli-LDL-immunisaation jälkeen sekä sen vaikutusta ateroskleroosin kehittymiseen tutkittiin LDL-reseptoripuutteellisilla hiirillä. Tutkimuksessa osoitettiin, että ihmisillä on plasmassa karbamyloituja proteiineja tunnistavia vasta-aineita. IgG-luokan vasta-aineet ovat yhteydessä uremiaan ja tupakointiin, joissa karbamylaatio on lisääntynyt. Karbamyyli- ja hapettuneita epitooppeja tunnistavien plasman IgG- ja IgM-vasta-aineiden välillä havaittiin olevan yhteys. Työssä kloonattiin terveistä ihmisistä monoklonaalisia Fab-vasta-aineita, joilla on luonnollisten vasta-aineiden kaltaisia ominaisuuksia ja kyky sitoutua sekä karbamyyli- että malonidialdehydi-epitooppeihin. Yksi tutkittu Fab-vasta-aine sitoutui valtimonkovettumataudin ateroomissa oleviin epitooppeihin ja esti muuntuneen LDL:n sisäänoton makrofagi-soluihin. Ihmisen plasman vasta-aineet ja monoklonaalinen Fab-vasta-aine sitoutuivat apoptoottisten solujen pinnalla oleviin rakenteisiin. Soluviljelyolosuhteissa ihmisen B-solut tuottivat vasta-aineita, joilla oli samanlaisia ristireaktio-ominaisuuksia karbamyyli- ja malonidialdehydi-epitooppeja sekä apoptoottisia soluja kohtaan. Karbamyyli-LDL-immunisaatio sai aikaan IgG-immuunivasteen hiirillä karbamyyli-LDL:a kohtaan, mutta myös ristireaktio malonidialdehydi-rakenteita sekä apoptoottisia soluja kohtaan havaittiin. Karbamyyli-LDL-immunisaatio ei vaikuttanut ateroskleroosin kehittymiseen hiirillä. Tutkimus osoittaa, että IgG-vasta-aineet karbamyyli-epitooppeja kohtaan voivat olla uudenlainen karbamylaation merkkiaine elimistössä ureemisilla potilailla ja tupakoitsijoilla. Karbamyloituneiden ja hapettuneiden epitooppien sekä apoptoottisten solujen välillä havaituilla vasta-aineiden ristireaktioilla voi olla merkitystä valtimonkovettumataudin etenemiseen munuaisten vajaatoiminnassa.

Elevada disponibilidade de bário (Ba) no meio de cultivo pode resultar em severa toxidez nas plantas. A toxidez causada pelo metal pesado nas plantas pode ser amenizada pelo fornecimento de nutrientes, particularmente o enxofre (S). Objetivou-se avaliar os parâmetros produtivos, sintomas visuais, estado nutricional, índice SPAD, indicadores de estresse (malondialdeído, peróxido de hidrogênio e prolina) e a atividade de enzimas do sistema antioxidante (glutationa redutase, superóxido dismutase, catalase, ascorbato peroxidase e guaiacol peroxidase) do capim tanzânia (Panicum maximum Jacq. cv. Tanzânia) cultivado com combinações de doses de S e de Ba na solução nutritiva, em casa de vegetação, em dois ciclos de crescimento das plantas. As plantas foram submetidas às combinações de cinco doses de S (0,1; 1,0; 1,9; 2,8 e 3,7 mmol L-1) com cinco doses de Ba (0,0; 2,5; 5,0; 10,0 e 20,0 mmol L-1), utilizando esquema fatorial fracionado (52), em blocos ao acaso, com seis repetições e seis plantas por unidade experimental. Os parâmetros produtivos e o estado nutricional das plantas foram severamente afetados pelas combinações de S e Ba em ambos os ciclos de crescimento. O aumento na dose de Ba na solução nutritiva prejudicou acentuadamente o crescimento e o estado nutricional das plantas, principalmente na área foliar, e nos nutrientes potássio e magnésio, enquanto o aumento da dose de S amenizou o efeito tóxico do metal. Maiores concentrações de malondialdeído foram observadas nas plantas que apresentaram maior acúmulo do metal pesado. As atividades das enzimas glutationa redutase, catalase e ascorbato peroxidase foram mais altas nas plantas cultivadas com baixo fornecimento de S, enquanto a atividade da guaiacol peroxidase foi aumentada com incremento das doses de Ba e de S. / High barium (Ba) availability in growth medium can cause severe toxicity in plants. Nutrient supply may mitigate heavy metal phytotoxicity, especially the sulphur (S) supply. The study was carried out to evaluate the plant growth, visual symptoms, nutritional status, indicators of stress (malondialdehyde, hydrogen peroxide and proline) and activities of the antioxidant enzymes (glutathione reductase, superoxide dismutase, catalase, ascorbate peroxidase and guaiacol peroxidase) in Tanzania guineagrass (Panicum maximum Jacq. cv. Tanzania) grown with combinations of S rates and Ba rates in nutrient solution, in a greenhouse, for two growth periods. Plants received nutrient solutions where combinations of five S rates (0.1, 1.0, 1.9, 2.8 and 3.7 mmol L-1) with five Ba rates (0.0, 2.5, 5.0, 10.0 and 20.0 mmol L-1) were used in a fractionated factorial (52), in randomized block design, with six replications and six plants per experimental unit. Plant production and nutritional status were highly affected by combinations of S and Ba rates, in both growth periods. Increase on Ba rates impaired growth, mainly on leaf area production. Barium rates impaired nutritional status, mainly on potassium and calcium, while increasing on S rates alleviated Ba toxic effects. High concentrations of malondialdehyde was observed in plants with increase of Ba application. The activities of catalase and ascorbate peroxidase were high in plants grown with low S availability, while guaiacol peroxidase activity was enhanced by increasing Ba and S rates in the nutrient solution.

Elevada disponibilidade de bário (Ba) no meio de cultivo pode resultar em severa toxidez nas plantas. A toxidez causada pelo metal pesado nas plantas pode ser amenizada pelo fornecimento de nutrientes, particularmente o enxofre (S). Objetivou-se avaliar os parâmetros produtivos, sintomas visuais, estado nutricional, índice SPAD, indicadores de estresse (malondialdeído, peróxido de hidrogênio e prolina) e a atividade de enzimas do sistema antioxidante (glutationa redutase, superóxido dismutase, catalase, ascorbato peroxidase e guaiacol peroxidase) do capim tanzânia (Panicum maximum Jacq. cv. Tanzânia) cultivado com combinações de doses de S e de Ba na solução nutritiva, em casa de vegetação, em dois ciclos de crescimento das plantas. As plantas foram submetidas às combinações de cinco doses de S (0,1; 1,0; 1,9; 2,8 e 3,7 mmol L-1) com cinco doses de Ba (0,0; 2,5; 5,0; 10,0 e 20,0 mmol L-1), utilizando esquema fatorial fracionado (52), em blocos ao acaso, com seis repetições e seis plantas por unidade experimental. Os parâmetros produtivos e o estado nutricional das plantas foram severamente afetados pelas combinações de S e Ba em ambos os ciclos de crescimento. O aumento na dose de Ba na solução nutritiva prejudicou acentuadamente o crescimento e o estado nutricional das plantas, principalmente na área foliar, e nos nutrientes potássio e magnésio, enquanto o aumento da dose de S amenizou o efeito tóxico do metal. Maiores concentrações de malondialdeído foram observadas nas plantas que apresentaram maior acúmulo do metal pesado. As atividades das enzimas glutationa redutase, catalase e ascorbato peroxidase foram mais altas nas plantas cultivadas com baixo fornecimento de S, enquanto a atividade da guaiacol peroxidase foi aumentada com incremento das doses de Ba e de S. / High barium (Ba) availability in growth medium can cause severe toxicity in plants. Nutrient supply may mitigate heavy metal phytotoxicity, especially the sulphur (S) supply. The study was carried out to evaluate the plant growth, visual symptoms, nutritional status, indicators of stress (malondialdehyde, hydrogen peroxide and proline) and activities of the antioxidant enzymes (glutathione reductase, superoxide dismutase, catalase, ascorbate peroxidase and guaiacol peroxidase) in Tanzania guineagrass (Panicum maximum Jacq. cv. Tanzania) grown with combinations of S rates and Ba rates in nutrient solution, in a greenhouse, for two growth periods. Plants received nutrient solutions where combinations of five S rates (0.1, 1.0, 1.9, 2.8 and 3.7 mmol L-1) with five Ba rates (0.0, 2.5, 5.0, 10.0 and 20.0 mmol L-1) were used in a fractionated factorial (52), in randomized block design, with six replications and six plants per experimental unit. Plant production and nutritional status were highly affected by combinations of S and Ba rates, in both growth periods. Increase on Ba rates impaired growth, mainly on leaf area production. Barium rates impaired nutritional status, mainly on potassium and calcium, while increasing on S rates alleviated Ba toxic effects. High concentrations of malondialdehyde was observed in plants with increase of Ba application. The activities of catalase and ascorbate peroxidase were high in plants grown with low S availability, while guaiacol peroxidase activity was enhanced by increasing Ba and S rates in the nutrient solution.

Die Störung der intestinalen Mikrozirkulation gilt als ein kardinaler Mechanismus für die Entwicklung des Multiorganversagens bei Sepsis. Da das Intestinum für mikrozirkulatorische Studien klinisch kaum zugänglich ist, wurden die Auswirkungen einer Therapie mit den antioxidativen Substanzen Oxypurinol und U-74389G (Lazaroid) bzw. den vasoaktiven Substanzen Iloprost (Prostacyclin-Analogon) und Dopexamin auf die intestinale Mikrozirkulation und die systemische Mediatorfreisetzung in einem Tiermodell mit moderater und hoher Endotoxin-Belastung untersucht. Die intravitalmikroskopische Untersuchung der Kapillarperfusion in der Muskularisschicht bei Endotoxinämie erbrachte eine Verbesserung durch Oxypurinol- und Dopexamingabe. Die Perfusion der Mukosa konnte vor allem durch eine Iloprostapplikation gesteigert werden. Die Endotoxin-induzierte, intestinale Leukozytenadhärenz wurde insbesondere durch die Behandlung mit den antioxidativen Substanzen vermindert. Beide therapeutischen Optionen bewirkten eine ca. 60 %ige Reduktion der initialen Tumornekrosefaktor-alpha-Freisetzung in der Versuchsreihe mit der niedrigeren Endotoxin-Dosis. Parallel dazu konnte anhand von Malondialdehyd-Analysen gezeigt werden, dass Oxypurinol und U-74389G wirksam die intestinale, Radikal-induzierte Lipidperoxidation verringerten. Der intestinale mikrovaskuläre Blutfluss konnte durch beide vasoaktiven Substanzen - sowohl bei moderater als auch bei erhöhter Endotoxin-Dosierung - signifikant gesteigert werden. Die Ergebnisse beider Teilstudien bestätigten, dass sowohl reaktive Sauerstoffspezies als auch eine inadäquate Perfusion in der Mikrozirkulation wesentliche pathogenetische Faktoren bei Endotoxinämie bzw. Sepsis darstellen und entsprechende Therapieformen indiziert und effektiv sind. Eine kombinierte Gabe beider Substanzklassen erscheint daher sinnvoll und sollte in weiteren tierexperimentellen und klinischen Studien evaluiert werden. / The disturbance of the intestinal microcirculation is regarded as a pivotal mechanism in the development of multiorgan failure related to sepsis. Since the intestine is clinically not accessible for microcirculatory studies, the effects of a therapy with the antioxidants oxypurinol and U-74389G (lazaroid) as well as the vasoactive substances iloprost (a prostacyclin analogue) and dopexamine on the intestinal microcirculation and the systemic mediator release was studied in an animal model with moderate and high endotoxin challenge. The intravital microscopic examination of the capillary perfusion in the muscularis layer of the intestine during endotoxemia revealed an improvement by administration of oxypurinol and dopexamine. The perfusion of the mucosa could be increased by iloprost administration. The amount of the endotoxin induced, intestinal leukocyte adherence was especially decreased by the treatment with the antioxidants. Both therapeutic options caused a 60 % reduction in the initial tumor necrosis factor-alpha-release in the experiments with the lower endotoxin dose. Malondialdehyde analyses showed that oxypurinol and U-74389G reduced effectively the intestinal, radical-induced lipid peroxidation. The intestinal microvascular blood flow could be significantly increased by both vasoactive substances - as well as with moderately than also with elevated endotoxin-dosage. The results of the study confirmed that both reactive oxygen-species as well as an inadequate perfusion in the microcirculation represent essential pathogenetic factors during endotoxemia as well as sepsis and index corresponding therapy-forms and participates effective. A combined offering both substance-classes appears therefore meaningfully and should be evaluated in further experimental and clinical studies.

Malondialdehyde (MDA) is a mutagenic and carcinogenic product of lipid peroxidation which has also been found at elevated levels in smokers. MDA reacts with nucleic acid bases to form pyrimidopurinone DNA adducts, of which 3-(2-deoxy-β-D-erythro-pentofuranosyl)pyrimidol[1,2-α]purin-10(3H)-one (M1dG) is the most abundant and has been linked to smoking. Mutations in the TP53 tumour suppressor gene are associated with half of all cancers. This research applied a multidisciplinary approach to investigate the toxic effects of MDA on the human lung fibroblasts MRC5, which have an intact p53 response, and their SV40 transformed counterpart, MRC5 SV2, which have a sequestered p53 response. Both cell lines were treated with MDA (0-1000 µM) for 24 and 48 h and subjected to a variety of analyses to examine cell proliferation, cell viability, cellular and nuclear morphology, apoptosis, p53 protein expression, DNA topography and M1dG adduct detection. For the first time, mutation sequencing of the 5’ untranslated region (UTR) of the TP53 gene in response to MDA treatment was carried out. The main findings were that both cell lines showed reduced proliferation and viability with increasing concentrations of MDA, the cell surface and nuclear morphology were altered, and levels of apoptosis and p53 protein expression appeared to increase. A LC MS-MS method for detection of M1dG adducts was developed and adducts were detected in CT-DNA treated with MDA in a dose-dependent manner. DNA appeared to become more fragmented with increasing MDA concentration, and the number of mutations in the 5’ UTR region of the TP53 gene also increased. The majority of mutations observed were insertions, compared to lung cancer mutation data where the majority were G to T transversions. This was unexpected, suggesting that tobacco smoke compounds have a different role in mutagenesis than endogenous lipid peroxidation. Thus, MDA has been found to have a clear effect on human lung fibroblasts at both the cellular and DNA level.

Liver disease is now a leading cause of non-AIDS related morbidity and mortality in people living with HIV (PLWH). The present study investigated the interplay between adverse lifestyle factors that are prevalent in PLWH, biological mediators of liver pathogenesis, and a non-invasive measure of liver fibrosis (FIB-4 index) in HIV mono- and HIV/HCV co-infected individuals. The results of this investigation in the Miami Adult Studies of HIV (MASH) cohort show that the odds of liver fibrosis progression significantly increased over two years for HIV mono-infected participants who drank alcohol hazardously (OR 3.038, P=0.048), and had BMI ≥ 28kg/m2 (OR 2.934, P=0.027). Cocaine use reduced the odds of advancing one stage of liver fibrosis (OR 0.228, P=0.038), but an interaction between high BMI and cocaine use slightly raised the odds by 4.8% of liver fibrosis progression (P=0.072). HIV/HCV co-infected participants showed interactions between cocaine use and high BMI with increased FIB-4 stage (OR 4.985, P= 0.034), however no lifestyle factors could independently predict FIB-4 stage in this group. Biological mediators previously associated with liver pathogenesis were associated with higher FIB-4 index over 2 years in a subset of (n=65) HIV mono-infected participants. Plasma measures of oxidative stress (% oxidized glutathione: OR 4.342, P= 0.046), hepatocyte-specific apoptosis (Cytokeratin-18 (CK-18): OR 1.008, P=0.021), and microbial endotoxin (lipopolysaccharide (LPS): OR 1.098, P= 0.097) were associated with having higher odds of progressing at least one stage of FIB-4 over 2 years. The same biological mediators were also associated with liver fibrosis within HIV infected people who also had a harmful lifestyle characteristic. FIB-4 index was significantly associated with % oxidized glutathione in obese subjects (β=0.563, P=0.018), TGF-β1 in cocaine users (β=0.858, P=0.027), and CK-18 in HIV infected individuals without any adverse lifestyle factors (β=0.435, P=0.015). Taken together, the findings of these studies describe interrelationships between HIV disease status, lifestyle, and biological mediators of liver fibrosis. The results show interactions between lifestyle conditions and the mediators of liver fibrosis may account for higher rates of liver disease in HIV infection. Research is warranted to develop personalized therapeutics for PLWH to curb the burden of liver disease.