ALT - Alanine Transaminase | Liver Tests

A forum investigating the similarities between COVID-19 and fluoride poisoning, thyroid dysfunction and Gq/11 pathways.
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ALT - Alanine Transaminase | Liver Tests

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Alanine Transaminase (ALT)
© 2021 PFPC

Alanine aminotransferase, usually referred to as ALT, is an enzyme that is concentrated primarily in the liver. ALT levels can increase when liver cells are damaged.

Elevated ALT levels are seen in COVID-19 patients (Benedé-Ubieto et al., 2021; Gan et al., 2021; Loomba et al., 2021). It has been proposed as a serum biomarker for disease severity.

ALT is also elevated in fluoride poisoning (Li et al., 2021; Shashi et al., 2011).


Benedé-Ubieto R, Estévez-Vázquez O, Flores-Perojo .V, Macías-Rodríguez RU, Ruiz-Margáin A, Martínez-Naves E, Regueiro JR, Ávila MA, Trautwein C, Bañares R, Bosch J, Cubero FJ, Nevzorova YA - "Abnormal Liver Function Test in Patients Infected with Coronavirus (SARS-CoV-2): A Retrospective Single-Center Study from Spain" J Clin Med 10(5):1039 (2021) doi: 10.3390/jcm10051039. PMID: 33802486; PMCID: PMC7959465

Gan Q, Gong B, Sun M, Cao Z, Zheng Y, Zhang Y, Wen P, Shen Y, Hong L, Hou T, Jia Y, Li W, Li H, Xie Q - "A High Percentage of Patients Recovered From COVID-19 but Discharged With Abnormal Liver Function Tests" Front Physiol 12:642922 (2021) doi: 10.3389/fphys.2021.642922. PMID: 33815147; PMCID: PMC8015938

Loomba RS, Villarreal EG, Farias JS, Aggarwal G, Aggarwal S, Flores S - "EXPRESS: Serum biomarkers for prediction of mortality in patients with COVID-19" Ann Clin Biochem. 2021 Apr 19:45632211014244. doi: 10.1177/00045632211014244. Epub ahead of print. PMID: 33874737

Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, Li Q, Jiang C, Zhou Y, Liu S, Ye C, Zhang P, Xing Y, Guo H, Tang W - "Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis." J Infect 23:S0163-4453(20)30234-6 (2020)
doi: 10.1016/j.jinf.2020.04.021. Epub ahead of print. PMID: 32335169; PMCID: PMC7177098


Tan A, Stepien KM, Narayana STK - "Carnitine palmitoyltransferase II deficiency and post-COVID vaccination rhabdomyolysis" QJM hcab077n (2021) doi: 10.1093/qjmed/hcab077. Epub ahead of print. PMID: 33871650; PMCID: PMC8083200.


Li Q, Li W, Lai Y, Xiao YL - "Analysis on results of occupational health examination in 677 workers exposed to inorganic fluorine" Chinese Journal of Industrial Hygiene and Occupational Diseases 39(5):382-384 (2021)

Yu YM, Zhou BH, Yang YL, Guo CX, Zhao J, Wang HW - "Estrogen Deficiency Aggravates Fluoride-Induced Liver Damage and Lipid Metabolism Disorder in Rats" Biol Trace Elem Res. 2021 Aug 15. doi: 10.1007/s12011-021-02857-1. Epub ahead of print. PMID: 34392477
"In addition, F- exposure increased (P < 0.05 or P < 0.01) serum aminotransferase (ALT), aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptidase (γ-GT) activities and total bilirubin (T-bil) level..."

Lu Y, Luo Q, Cui H, Deng H, Kuang P, Liu H, Fang J, Zuo Z, Deng J, Li Y, Wang X, Zhao L - "Sodium fluoride causes oxidative stress and apoptosis in the mouse liver" Aging (Albany NY) 9(6):1623-1639 (2017)

Zhao L, Yu Y, Deng C - "Expression of sonic hedgehog signaling pathway and its inhibition by cyclopamine in rat liver with chronic fluorosis". Chinese Journal of Pathology 43(12):814-9 (2014)

Shashi A, Bhardwaj M - "Study on blood biochemical diagnostic indices for hepatic function biomarkers in endemic skeletal fluorosis" Biol Trace Elem Res 143(2):803-14 (2011)


[Basic pathway: Gq/11 protein --> phospholipase C [PLC] --> diacylglycerol [DAG] --> classical PKC --> NAD(P)H oxidase --> superoxide --> superoxide dismutase [SOD] --> H(2)O(2) --> mitogen-activated extracellular signal-regulated kinase [MAPK] --> ERK]

Jayakumar T, Hou SM, Chang CC, Fong TH, Hsia CW, Chen YJ, Huang WC, Saravanabhavan P, Manubolu M, Sheu JR, Hsia CH - "Columbianadin Dampens In Vitro Inflammatory Actions and Inhibits Liver Injury via Inhibition of NF-κB/MAPKs: Impacts on ∙OH Radicals and HO-1 Expression" Antioxidants (Basel) 10(4):553 (2021)

Pan J, Chen S, Guo W, Cao S, Shi X, Zhang J, Zhang H, Zhang S - "Alpinetin protects against hepatic ischemia/reperfusion injury in mice by inhibiting the NF-κB/MAPK signaling pathways" Int Immunopharmacol 95:107527 (2021)


Patel R, Dave C, Mehta S, Mendpara H, Shukla R, Bajpai A - "Metabolic Impact of Subclinical Hypothyroidism in Obese Children and Adolescents" Indian J Pediatr 88(5):437-440 (2021)

Manka P, Bechmann L, Best J, Sydor S, Claridge LC, Coombes JD, Canbay A, Moeller L, Gerken G, Wedemeyer H, Syn WK - "Low Free Triiodothyronine Is Associated with Advanced Fibrosis in Patients at High Risk for Nonalcoholic Steatohepatitis" Dig Dis Sci 64(8):2351-2358 (2019)
"fT3 and TSH values correlated significantly with indices of liver disease including INR, albumin, ALT, AST, bilirubin, and platelets."

Esmaeilizadeh M, Hosseini M, Beheshti F, Alikhani V, Keshavarzi Z, Shoja M, Mansoorian M, Sadeghnia HR - "Vitamin C improves liver and renal functions in hypothyroid rats by reducing tissue oxidative injury" Int J Vitam Nutr Res 90(1-2):84-94 (2020)


Patel R, Dave C, Mehta S, Mendpara H, Shukla R, Bajpai A - "Metabolic Impact of Subclinical Hypothyroidism in Obese Children and Adolescents" Indian J Pediatr 88(5):437-440 (2021)
"Thyroid stimulating hormone (TSH) was the most important determinant of ALT on linear regression (B = 3.027, p < 0.005)."


AST. viewtopic.php?f=66&t=1891
NF-κB. viewtopic.php?f=66&t=1888
ERK/MAPK. viewtopic.php?f=66&t=1914
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