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Hernandez JE, Llorente C, Ma S, Miyamoto KT, Sinha S, Steele S, Xiao Z, Lai CJ, Zuniga EI, Ghosh P, Schnabl B, Huang WJM. The arginine methyltransferase PRMT5 promotes mucosal defense in the intestine. Life Sci Alliance 2023; 6:e202302026. [PMID: 37666668 PMCID: PMC10477432 DOI: 10.26508/lsa.202302026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
PRMT5 is a type II arginine methyltransferase abundantly expressed in the colonic epithelium. It is up-regulated in inflammatory bowel disease and colorectal cancer. However, its role in mucosal defense against enteric infection has not been studied. Here, we report that Prmt5 in the murine colon is up-regulated in response to Citrobacter rodentium infection. Pathogen clearance in mice with haploinsufficient expression of Prmt5 is significantly delayed compared with wildtype littermate controls. Transcriptomic analyses further reveal that PRMT5 regulates the expression of canonical crypt goblet cell genes involved in mucus production, assembly, and anti-microbial responses via methyltransferase activity-dependent and -independent mechanisms. Together, these findings uncover PRMT5 as a novel regulator of mucosal defense and a potential therapeutic target for treating intestinal diseases.
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Affiliation(s)
- Juan E Hernandez
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Cristina Llorente
- https://ror.org/0168r3w48 Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Shengyun Ma
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Kiana T Miyamoto
- https://ror.org/0168r3w48 Division of Biological Sciences, University of California San Diego, La Jolla, CA, USA
| | - Saptarshi Sinha
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Scarlet Steele
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Zihui Xiao
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Ching-Jung Lai
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Elina I Zuniga
- https://ror.org/0168r3w48 Division of Biological Sciences, University of California San Diego, La Jolla, CA, USA
| | - Pradipta Ghosh
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
- https://ror.org/0168r3w48 Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Bernd Schnabl
- https://ror.org/0168r3w48 Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Wendy Jia Men Huang
- https://ror.org/0168r3w48 Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
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Llorente C, Rungratanawanich W, Liangpunsakul S. Intestinal dendritic cells, gatekeepers preventing ethanol-induced liver disease. Hepatology 2023; 78:697-701. [PMID: 36930746 PMCID: PMC10315410 DOI: 10.1097/hep.0000000000000236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 03/19/2023]
Affiliation(s)
- Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Wiramon Rungratanawanich
- Section of Molecular Pharmacology and Toxicology, National Institute on Alcohol Abuse and Alcoholism, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
- Roudebush Veterans Administration Medical Center, Indianapolis, IN
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Fuster D, Llorente C, Garcia-Calvo X, Bolao F, Zuluaga P, Hernández-Rubio A, Casado-Carbajo J, Leis A, Muga R. Fungal plasma biomarkers in patients admitted for inpatient treatment of alcohol use disorder. Alcohol Clin Exp Res (Hoboken) 2023; 47:1582-1589. [PMID: 37364901 PMCID: PMC10984271 DOI: 10.1111/acer.15140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Fungal plasma biomarkers have not been studied in patients with unhealthy alcohol use and no apparent end-stage liver disease. METHODS We examined the prevalence of fungal plasma biomarkers, assessed by the presence of anti-Saccharomyces cerevisiae antibodies (ASCA; IgA and IgM), and its disease correlates in patients with alcohol use disorder (AUD). We performed logistic regression analyses to detect the association between clinical and laboratory characteristics and the presence of fungal plasma biomarkers. RESULTS We included 395 patients (75.9% male, median age of 49 years, and median body mass index of 25.6) who drank a median of 150 g of alcohol daily and had a median duration of AUD of 20 years. ASCA IgA and IgG were present in 34.4% and 14.9%, respectively, and 9.9% had both ASCA IgA and ASCA IgG. The presence of ASCA IgA was associated with male sex (p < 0.01); values of serum aspartate transferase (AST) (p = 0.02), gamma-glutamyl transferase (GGT) (p < 0.01), alkaline phosphatase (ALP) (p < 0.01), and bilirubin in the highest quartile (p < 0.01); Fibrosis-4 Index (FIB-4) values suggestive of advanced liver fibrosis (p < 0.01); and values of the macrophage activation factors sCD163 (p < 0.01) and sCD14 (p < 0.01), the cytokine IL-6 (p = 0.01), and lipopolysaccharide-binding protein in the highest quartile (p < 0.01). The presence of ASCA IgG was associated with omeprazole use (p = 0.04); values of AST (p = 0.04) and GGT (p = 0.04) in the highest quartile; FIB-4 values suggestive of advanced liver fibrosis (p < 0.01); and values of sCD163 (p < 0.01) in the highest quartile. The variables associated with the presence of both ASCA IgA and IgG were male sex (p = 0.04) and values of GGT (p = 0.04) and sCD163 in the highest quartile (p < 0.01). CONCLUSIONS In AUD patients, the presence of fungal biomarkers in plasma was common and associated with FIB-4 values suggestive of advanced liver fibrosis and with markers of liver damage, monocyte activation, and microbial translocation, male gender, and omeprazole use. These findings suggest that the presence of plasma anti-Saccharomyces cerevisiae antibodies could be used as a biomarker for an elevated risk of progressive liver disease in patients with AUD.
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Affiliation(s)
- Daniel Fuster
- Department of Internal Medicine. Addiction Unit. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Xavier Garcia-Calvo
- Department of Internal Medicine. Addiction Unit. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Ferran Bolao
- Department of Internal Medicine. Hospital Universitari de Bellvitge. Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain
| | - Paola Zuluaga
- Department of Internal Medicine. Addiction Unit. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Anna Hernández-Rubio
- Department of Internal Medicine. Addiction Unit. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Julia Casado-Carbajo
- Department of Internal Medicine. Addiction Unit. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Alba Leis
- Department of Biochemistry. Hospital Universitari Germans Trias i Pujol de Badalona. Badalona (Barcelona), Spain
| | - Robert Muga
- Department of Internal Medicine. Addiction Unit. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
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Cabré N, Hartmann P, Llorente C, Kouno T, Wang Y, Zeng S, Kim HY, Zhang X, Kisseleva T, Iyer S, Kudumala S, Schnabl B. IgY antibodies against cytolysin reduce ethanol-induced liver disease in mice. Hepatology 2023; 78:295-306. [PMID: 36811393 PMCID: PMC10293100 DOI: 10.1097/hep.0000000000000324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/11/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND AND AIMS Patients with severe alcohol-associated hepatitis have high morbidity and mortality. Novel therapeutic approaches are urgently needed. The aims of our study were to confirm the predictive value of cytolysin-positive Enterococcus faecalis ( E. faecalis ) for mortality in patients with alcohol-associated hepatitis and to assess the protective effect of specific chicken immunoglobulin Y (IgY) antibodies against cytolysin in vitro and in a microbiota-humanized mouse model of ethanol-induced liver disease. APPROACH AND RESULTS We investigated a multicenter cohort of 26 subjects with alcohol-associated hepatitis and confirmed our previous findings that the presence of fecal cytolysin-positive E. faecalis predicted 180-day mortality in those patients. After combining this smaller cohort with our previously published multicenter cohort, the presence of fecal cytolysin has a better diagnostic area under the curve, better other accuracy measures, and a higher odds ratio to predict death in patients with alcohol-associated hepatitis than other commonly used liver disease models. In a precision medicine approach, we generated IgY antibodies against cytolysin from hyperimmunized chickens. Neutralizing IgY antibodies against cytolysin reduced cytolysin-induced cell death in primary mouse hepatocytes. The oral administration of IgY antibodies against cytolysin decreased ethanol-induced liver disease in gnotobiotic mice colonized with stool from cytolysin-positive patients with alcohol-associated hepatitis. CONCLUSIONS E. faecalis cytolysin is an important mortality predictor in alcohol-associated hepatitis patients, and its targeted neutralization through specific antibodies improves ethanol-induced liver disease in microbiota-humanized mice.
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Affiliation(s)
- Noemí Cabré
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
- Division of Gastroenterology, Hepatology & Nutrition, Rady Children’s Hospital San Diego, San Diego, CA, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Tetsuya Kouno
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Yanhan Wang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Suling Zeng
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Hyun Young Kim
- Department of Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Xinlian Zhang
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Tatiana Kisseleva
- Department of Surgery, University of California, San Diego, La Jolla, CA, USA
| | | | | | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
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Hsu CL, Wang Y, Duan Y, Chu H, Hartmann P, Llorente C, Zhou R, Schnabl B. Differences in Bacterial Translocation and Liver Injury in Ethanol Versus Diet-Induced Liver Disease. Dig Dis Sci 2023; 68:3059-3069. [PMID: 36807831 PMCID: PMC10313731 DOI: 10.1007/s10620-023-07860-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Alcohol-associated liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) are two of the most common etiologies of chronic liver disease worldwide. Changes in intestinal permeability and increased gut microbial translocation have been posited as important contributors to inflammation in both ALD and NAFLD. However, gut microbial translocation has not been compared between the two etiologies and can lead to better understanding of the differences in their pathogenesis to liver disease. METHODS We compared serum and liver markers in the following five models of liver disease to understand the differences in the role of gut microbial translocation on liver disease progression caused by ethanol versus Western diet: (1) 8-week chronic ethanol feeding model. (2) 2-week chronic-plus-binge (National Institute on Alcohol Abuse and Alcoholism (NIAAA)) ethanol feeding model. (3) 2-week chronic-plus-binge (NIAAA) ethanol feeding model in microbiota-humanized gnotobiotic mice colonized with stool from patients with alcohol-associated hepatitis. (4) 20-week Western-diet-feeding model of NASH. (5) 20-week Western-diet-feeding model in microbiota-humanized gnotobiotic mice colonized with stool from NASH patients. RESULTS Translocation of bacterial lipopolysaccharide to the peripheral circulation was seen in both ethanol-induced and diet-induced liver disease, but translocation of bacteria itself was restricted to only ethanol-induced liver disease. Moreover, the diet-induced steatohepatitis models developed more significant liver injury, inflammation, and fibrosis compared with ethanol-induced liver disease models, and this positively correlated with the level of lipopolysaccharide translocation. CONCLUSIONS More significant liver injury, inflammation, and fibrosis are seen in diet-induced steatohepatitis, which positively correlates with translocation of bacterial components, but not intact bacteria.
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Affiliation(s)
- Cynthia L Hsu
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA
| | - Yanhan Wang
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Yi Duan
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Huikuan Chu
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Phillipp Hartmann
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Division of Gastroenterology, Hepatology & Nutrition, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA
| | - Rongrong Zhou
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, MC0063, USA.
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA.
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Kouno T, Zeng S, Wang Y, Duan Y, Lang S, Gao B, Hartmann P, Cabré N, Llorente C, Galbert C, Emond P, Sokol H, James M, Chao CC, Gao JR, Perreault M, Hava DL, Schnabl B. Engineered bacteria producing aryl-hydrocarbon receptor agonists protect against ethanol-induced liver disease in mice. Alcohol Clin Exp Res (Hoboken) 2023; 47:856-867. [PMID: 36871955 PMCID: PMC10795770 DOI: 10.1111/acer.15048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND AND PURPOSE Gut bacteria metabolize tryptophan into indoles. Intestinal levels of the tryptophan metabolite indole-3-acetic acid are reduced in patients with alcohol-associated hepatitis. Supplementation of indole-3-acetic acid protects against ethanol-induced liver disease in mice. The aim of this study was to evaluate the effect of engineered bacteria producing indoles as Aryl-hydrocarbon receptor (Ahr) agonists. METHODS C57BL/6 mice were subjected to chronic-plus-binge ethanol feeding and orally given PBS, control Escherichia coli Nissle 1917 (EcN) or engineered EcN-Ahr. The effects of EcN and EcN-Ahr were also examined in mice lacking Ahr in interleukin 22 (Il22)-producing cells. RESULTS Through the deletion of endogenous genes trpR and tnaA, coupled with overexpression of a feedback-resistant tryptophan biosynthesis operon, EcN-Ahr were engineered to overproduce tryptophan. Additional engineering allowed conversion of this tryptophan to indoles including indole-3-acetic acid and indole-3-lactic acid. EcN-Ahr ameliorated ethanol-induced liver disease in C57BL/6 mice. EcN-Ahr upregulated intestinal gene expression of Cyp1a1, Nrf2, Il22, Reg3b, and Reg3g, and increased Il22-expressing type 3 innate lymphoid cells. In addition, EcN-Ahr reduced translocation of bacteria to the liver. The beneficial effect of EcN-Ahr was abrogated in mice lacking Ahr expression in Il22-producing immune cells. CONCLUSIONS Our findings indicate that tryptophan metabolites locally produced by engineered gut bacteria mitigate liver disease via Ahr-mediated activation in intestinal immune cells.
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Affiliation(s)
- Tetsuya Kouno
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Suling Zeng
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Yanhan Wang
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Sonja Lang
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany
| | - Bei Gao
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
- Division of Gastroenterology, Hepatology & Nutrition, Rady Children’s Hospital San Diego, San Diego, CA, USA
| | - Noemí Cabré
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Chloé Galbert
- Sorbonne Université, INSERM UMRS-938, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Paris, France
- Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
| | - Patrick Emond
- UMR 1253, iBrain, University of Tours, Inserm, 37044 Tours, France
- CHRU Tours, Medical Biology Center, 37000 Tours, France
| | - Harry Sokol
- Sorbonne Université, INSERM UMRS-938, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Paris, France
- Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
- INRAe, AgroParisTech, Micalis institute, Jouy-en-Josas, France
| | | | | | | | | | | | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, 92093, USA
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Zeng S, Hartmann P, Park M, Duan Y, Lang S, Llorente C, Wang Y, Cabré N, Fouts DE, Bacher P, Jung WH, Stärkel P, Schnabl B. Malassezia restricta promotes alcohol-induced liver injury. Hepatol Commun 2023; 7:e0029. [PMID: 36706195 PMCID: PMC9988279 DOI: 10.1097/hc9.0000000000000029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/31/2022] [Indexed: 01/29/2023] Open
Abstract
Chronic alcohol consumption is associated with intestinal fungal dysbiosis, yet we understand little about how alterations of intestinal fungi (mycobiota) contribute to the pathogenesis of alcohol-associated liver disease. By reanalyzing internal transcribed spacer 2 amplicon sequencing of fecal samples from a cohort of 66 patients with alcohol use disorder for presence (as opposed to relative abundance) of fungal species, we observed that the presence of Malassezia restricta was associated with increased markers of liver injury. M. restricta exacerbates ethanol-induced liver injury both in acute binge and chronic ethanol-feeding models in mice. Using bone marrow chimeric mice, we found that the disease exacerbating effect by M. restricta was mediated by C-type lectin domain family 4, member N on bone marrow-derived cells. M. restricta induces inflammatory cytokines and chemokines in Kupffer cells through C-type lectin domain family 4, member N signaling. Targeting fungal pathobionts might be a therapeutic strategy for alcohol-associated liver disease.
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Affiliation(s)
- Suling Zeng
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
| | - Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Division of Gastroenterology, Hepatology & Nutrition, Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Minji Park
- Department of Systems Biotechnology, Chung-Ang University, Anseong-Si, Korea
| | - Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Sonja Lang
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Gastroenterology and Hepatology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Yanhan Wang
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
| | - Noemí Cabré
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Derrick E. Fouts
- Genomic Medicine, J. Craig Venter Institute, Rockville, Maryland, USA
| | - Petra Bacher
- Institute of Immunology, Christian-Albrechts-University of Kiel & UKSH Schleswig-Holstein, Kiel, Germany
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Won Hee Jung
- Department of Systems Biotechnology, Chung-Ang University, Anseong-Si, Korea
| | - Peter Stärkel
- St. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
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Guijarro A, Castro A, Hernández V, de la Peña E, Sánchez-Rosendo L, Jiménez E, Pérez-Férnandez E, Llorente C. Population based study of morbidity and mortality rates associated to radical prostatectomy cases in Spain. Actas Urol Esp 2022; 46:619-628. [PMID: 36280035 DOI: 10.1016/j.acuroe.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/28/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION There is no population-based study that accounts for the number of radical prostatectomies (RP) carried out in Spain, nor regarding the morbidity and mortality of this intervention. Our objective is to study the morbidity and mortality of RP in Spain from 2011 to 2015 and to evaluate the geographic variation. MATERIAL AND METHODS We designed a retrospective observational study of all patients submitted to RP in Spain during five consecutive years (2011-2015). The data was extracted from the «Conjunto Mínimo Básico de Datos» (CMBD). We have evaluated geographic variations in terms of morbidity and hospital stay, and the impact of the mean annual surgical volume for each center on these variables. RESULTS Between 2011-2015, a total of 37,725 RPs were performed in 221 Spanish public hospitals. The mean age of the series was 63.9±3.23 years. Of all RPs, 50% were performed through an open approach, and 43.4% have been operated on in hospitals with <500 beds. We observed an important variability in the distribution of the cases operated on in the different regions. The regions that perform more RPs are Andalusia, Catalonia, Galicia, and Madrid. Our study shows a complication rate of 8.6%, with hemorrhage and the need for transfusion being the most frequent (5.3 and 4%, respectively). There are significant differences in bleeding rates and hospital stay among regions, which are maintained after adjusting for patient characteristics and type of hospital. When studying the annual surgical volume of each hospital, we find that the impact on the rate of hemorrhage or transfusion is linear; however, hospital stay remains stable at around 5 days from 60 RPs/year. CONCLUSIONS In national terms, morbidity and mortality rates after RP are comparable to those described in the literature. This study reveals a clear dispersion in the hospitals that carry out this intervention, showing clear differences in terms of morbidity and hospital stay between the different regions.
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Affiliation(s)
- A Guijarro
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - A Castro
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - V Hernández
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - E de la Peña
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - L Sánchez-Rosendo
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - E Jiménez
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - E Pérez-Férnandez
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - C Llorente
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Murillo-Saich JD, Coras R, Meyer R, Llorente C, Lane NE, Guma M. Synovial tissue metabolomic profiling reveal biomarkers of synovial inflammation in patients with osteoarthritis. Osteoarthr Cartil Open 2022; 4:100295. [PMID: 36474936 PMCID: PMC9718344 DOI: 10.1016/j.ocarto.2022.100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 01/30/2023] Open
Abstract
Objective Inflammatory responses are associated with changes in tissue metabolism. Prior studies find altered metabolomic profiles in both the synovial fluid (SF) and serum of osteoarthritis subjects. Our study determined the metabolomic profile of synovial tissue (ST) and SF of individuals with osteoarthritis (OA) and its association with synovial inflammation. Design 37 OA ST samples were collected during joint replacement, 21 also had SF. ST samples were fixed in formalin for histological analysis, cultured (explants) for cytokine analysis by enzyme-linked immunosorbent assay, or snap-frozen for metabolomic analysis. ST samples were categorized by Krenn synovitis score and picrosirius red. CD68 and vimentin expression was assessed by immunohistochemistry and semi-quantified using Image J. Proton-nuclear magnetic resonance (1H NMR) was used to acquire a spectrum from ST and SF samples. Chenomx NMR suite 8.5 was used for metabolite identification and quantification. Metaboanalyst 5.0, SPSS v26, and R (v4.1.2) were used for statistical analysis. Results 42 and 29 metabolites were detected in the ST and SF respectively by 1H NMR. Only 3 metabolites, lactate, dimethylamine, and creatine positively correlated between SF and ST. ST concentrations of several metabolites (lactate, alanine, fumarate, glutamine, glycine, leucine, lysine, methionine, trimethylamine N-oxide, tryptophan and valine) were associated with synovitis score, mostly to the lining score. IL-6, acetoacetate, and tyrosine in SF predicted high Krenn synovitis scores in ST. Conclusion Metabolomic profiling of ST identified metabolic changes associated with inflammation. Further studies are needed to determine whether metabolomic profiling of synovial tissue can identify new therapeutic targets in osteoarthritis.
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Affiliation(s)
- Jessica D. Murillo-Saich
- Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Roxana Coras
- Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
- Department of Medicine, Autonomous University of Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain
| | - Robert Meyer
- Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
- San Diego VA Healthcare Service, San Diego, CA, 92161, USA
| | - Cristina Llorente
- Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Nancy E. Lane
- Department of Medicine, University of California, Davis, Sacramento, CA, 95817, USA
| | - Monica Guma
- Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
- Department of Medicine, Autonomous University of Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain
- San Diego VA Healthcare Service, San Diego, CA, 92161, USA
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10
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Guijarro A, Castro A, Hernández V, de la Peña E, Sánchez-Rosendo L, Jiménez E, Pérez-Férnandez E, Llorente C. Estudio poblacional de casuística y morbimortalidad de la prostatectomía radical en España. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Duan Y, Chu H, Brandl K, Jiang L, Zeng S, Meshgin N, Papachristoforou E, Argemi J, Mendes BG, Wang Y, Su H, Sun W, Llorente C, Hendrikx T, Liu X, Hosseini M, Kisseleva T, Brenner DA, Bataller R, Ramachandran P, Karin M, Fu W, Schnabl B. CRIg on liver macrophages clears pathobionts and protects against alcoholic liver disease. Nat Commun 2021; 12:7172. [PMID: 34887405 PMCID: PMC8660815 DOI: 10.1038/s41467-021-27385-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/15/2021] [Indexed: 12/19/2022] Open
Abstract
Complement receptor of immunoglobulin superfamily (CRIg) is expressed on liver macrophages and directly binds complement component C3b or Gram-positive bacteria to mediate phagocytosis. CRIg plays important roles in several immune-mediated diseases, but it is not clear how its pathogen recognition and phagocytic functions maintain homeostasis and prevent disease. We previously associated cytolysin-positive Enterococcus faecalis with severity of alcohol-related liver disease. Here, we demonstrate that CRIg is reduced in liver tissues from patients with alcohol-related liver disease. CRIg-deficient mice developed more severe ethanol-induced liver disease than wild-type mice; disease severity was reduced with loss of toll-like receptor 2. CRIg-deficient mice were less efficient than wild-type mice at clearing Gram-positive bacteria such as Enterococcus faecalis that had translocated from gut to liver. Administration of the soluble extracellular domain CRIg-Ig protein protected mice from ethanol-induced steatohepatitis. Our findings indicate that ethanol impairs hepatic clearance of translocated pathobionts, via decreased hepatic CRIg, which facilitates progression of liver disease.
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Affiliation(s)
- Yi Duan
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.410371.00000 0004 0419 2708Department of Medicine, VA San Diego Healthcare System, San Diego, CA USA
| | - Huikuan Chu
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.33199.310000 0004 0368 7223Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, 430022 Wuhan, China
| | - Katharina Brandl
- grid.266100.30000 0001 2107 4242Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA USA
| | - Lu Jiang
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.410371.00000 0004 0419 2708Department of Medicine, VA San Diego Healthcare System, San Diego, CA USA
| | - Suling Zeng
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.410371.00000 0004 0419 2708Department of Medicine, VA San Diego Healthcare System, San Diego, CA USA
| | - Nairika Meshgin
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Eleni Papachristoforou
- grid.511172.10000 0004 0613 128XUniversity of Edinburgh Centre for Inflammation Research, The Queen’s Medical Research Institute, Edinburgh BioQuarter, Edinburgh, UK
| | - Josepmaria Argemi
- grid.412689.00000 0001 0650 7433Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh Liver Research Center, Pittsburgh, PA USA ,grid.5924.a0000000419370271Hepatology Program, Centro de Investigacion Medica Aplicada (CIMA), Liver Unit, Clinica Universidad de Navarra (CUN), Instituto de Investigacion de Navarra (IdisNA), University of Navarra, Pamplona, Spain
| | - Beatriz G. Mendes
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Yanhan Wang
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.410371.00000 0004 0419 2708Department of Medicine, VA San Diego Healthcare System, San Diego, CA USA
| | - Hua Su
- grid.266100.30000 0001 2107 4242Laboratory of Gene Regulation and Signal Transduction, Departments of Pharmacology and Pathology, School of Medicine, University of California San Diego, La Jolla, CA USA
| | - Weizhong Sun
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Cristina Llorente
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Tim Hendrikx
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Xiao Liu
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Department of Surgery, University of California San Diego, La Jolla, CA USA
| | - Mojgan Hosseini
- grid.266100.30000 0001 2107 4242Department of Pathology, University of California San Diego, La Jolla, CA USA
| | - Tatiana Kisseleva
- grid.266100.30000 0001 2107 4242Department of Surgery, University of California San Diego, La Jolla, CA USA
| | - David A. Brenner
- grid.266100.30000 0001 2107 4242Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Ramon Bataller
- grid.412689.00000 0001 0650 7433Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh Liver Research Center, Pittsburgh, PA USA
| | - Prakash Ramachandran
- grid.511172.10000 0004 0613 128XUniversity of Edinburgh Centre for Inflammation Research, The Queen’s Medical Research Institute, Edinburgh BioQuarter, Edinburgh, UK
| | - Michael Karin
- grid.266100.30000 0001 2107 4242Laboratory of Gene Regulation and Signal Transduction, Departments of Pharmacology and Pathology, School of Medicine, University of California San Diego, La Jolla, CA USA
| | - Wenxian Fu
- grid.266100.30000 0001 2107 4242Department of Pediatrics, University of California San Diego, La Jolla, CA USA ,grid.418158.10000 0004 0534 4718Department of Cancer Immunology, Genentech, South San Francisco, CA USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA. .,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA.
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12
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Cabré N, Duan Y, Llorente C, Conrad M, Stern P, Yamashita D, Schnabl B. Colesevelam Reduces Ethanol-Induced Liver Steatosis in Humanized Gnotobiotic Mice. Cells 2021; 10:cells10061496. [PMID: 34198609 PMCID: PMC8232222 DOI: 10.3390/cells10061496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 12/12/2022] Open
Abstract
Alcohol-related liver disease is associated with intestinal dysbiosis. Functional changes in the microbiota affect bile acid metabolism and result in elevated serum bile acids in patients with alcohol-related liver disease. The aim of this study was to identify the potential role of the bile acid sequestrant colesevelam in a humanized mouse model of ethanol-induced liver disease. We colonized germ-free (GF) C57BL/6 mice with feces from patients with alcoholic hepatitis and subjected humanized mice to the chronic–binge ethanol feeding model. Ethanol-fed gnotobiotic mice treated with colesevelam showed reduced hepatic levels of triglycerides and cholesterol, but liver injury and inflammation were not decreased as compared with non-treated mice. Colesevelam reduced hepatic cytochrome P450, family 7, subfamily a, polypeptide 1 (Cyp7a1) protein expression, although serum bile acids were not lowered. In conclusion, our findings indicate that colesevelam treatment mitigates ethanol-induced liver steatosis in mice.
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Affiliation(s)
- Noemí Cabré
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (N.C.); (Y.D.); (C.L.)
| | - Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (N.C.); (Y.D.); (C.L.)
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (N.C.); (Y.D.); (C.L.)
| | - Mary Conrad
- Axial Therapeutics, Woburn, MA 01801, USA; (M.C.); (P.S.); (D.Y.)
| | - Patrick Stern
- Axial Therapeutics, Woburn, MA 01801, USA; (M.C.); (P.S.); (D.Y.)
| | - Dennis Yamashita
- Axial Therapeutics, Woburn, MA 01801, USA; (M.C.); (P.S.); (D.Y.)
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (N.C.); (Y.D.); (C.L.)
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Correspondence:
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13
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García Fuentes C, Jiménez Alcaide E, Hernández V, De La Pena Zarzuelo E, Guijarro Cascales A, Castro Fajardo A, Pérez-Fernández E, Llorente C. Severity of COVID-19 infection in prostate cancer patients and effect of ADT on disease presentation. Eur Urol 2021. [PMCID: PMC8263116 DOI: 10.1016/s0302-2838(21)01223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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14
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Zhou R, Llorente C, Cao J, Zaramela LS, Zeng S, Gao B, Li SZ, Welch RD, Huang FQ, Qi LW, Pan C, Huang Y, Zhou P, Beussen I, Zhang Y, Bryam G, Fiehn O, Wang L, Liu EH, Yu RT, Downes M, Evans RM, Goglin K, Fouts DE, Brenner DA, Bode L, Fan X, Zengler K, Schnabl B. Intestinal α1-2-Fucosylation Contributes to Obesity and Steatohepatitis in Mice. Cell Mol Gastroenterol Hepatol 2021; 12:293-320. [PMID: 33631374 PMCID: PMC8166943 DOI: 10.1016/j.jcmgh.2021.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Fucosyltransferase 2 (Fut2)-mediated intestinal α1- 2-fucosylation is important for host-microbe interactions and has been associated with several diseases, but its role in obesity and hepatic steatohepatitis is not known. The aim of this study was to investigate the role of Fut2 in a Western-style diet-induced mouse model of obesity and steatohepatitis. METHODS Wild-type (WT) and Fut2-deficient littermate mice were used and features of the metabolic syndrome and steatohepatitis were assessed after 20 weeks of Western diet feeding. RESULTS Intestinal α1-2-fucosylation was suppressed in WT mice after Western diet feeding, and supplementation of α1-2-fucosylated glycans exacerbated obesity and steatohepatitis in these mice. Fut2-deficient mice were protected from Western diet-induced features of obesity and steatohepatitis despite an increased caloric intake. These mice have increased energy expenditure and thermogenesis, as evidenced by a higher core body temperature. Protection from obesity and steatohepatitis associated with Fut2 deficiency is transmissible to WT mice via microbiota exchange; phenotypic differences between Western diet-fed WT and Fut2-deficient mice were reduced with antibiotic treatment. Fut2 deficiency attenuated diet-induced bile acid accumulation by altered relative abundance of bacterial enzyme 7-α-hydroxysteroid dehydrogenases metabolizing bile acids and by increased fecal excretion of secondary bile acids. This also was associated with increased intestinal farnesoid X receptor/fibroblast growth factor 15 signaling, which inhibits hepatic synthesis of bile acids. Dietary supplementation of α1-2-fucosylated glycans abrogates the protective effects of Fut2 deficiency. CONCLUSIONS α1-2-fucosylation is an important host-derived regulator of intestinal microbiota and plays an important role for the pathogenesis of obesity and steatohepatitis in mice.
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Affiliation(s)
- Rongrong Zhou
- Department of Infectious Diseases, Xiangya Hospital, Central South University and Key Laboratory of Viral Hepatitis, Hunan, Changsha, China; Department of Medicine, University of California San Diego, La Jolla, California
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Jinling Cao
- Department of Medicine, University of California San Diego, La Jolla, California; College of Food Science and Engineering, Shanxi Agricultural University, Shanxi, Taigu, China
| | - Livia S Zaramela
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Suling Zeng
- Department of Medicine, University of California San Diego, La Jolla, California; State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Bei Gao
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Shang-Zhen Li
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Ryan D Welch
- Gene Expression Laboratory, Salk Institute for Biological Studies, San Diego, California
| | - Feng-Qing Huang
- The Clinical Metabolomics Center, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Lian-Wen Qi
- The Clinical Metabolomics Center, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Chuyue Pan
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Yan Huang
- Department of Infectious Diseases, Xiangya Hospital, Central South University and Key Laboratory of Viral Hepatitis, Hunan, Changsha, China
| | - Pengchen Zhou
- Department of Infectious Diseases, Xiangya Hospital, Central South University and Key Laboratory of Viral Hepatitis, Hunan, Changsha, China
| | - Iris Beussen
- National Institutes of Health West Coast Metabolomics Center, University of California, Davis, California
| | - Ying Zhang
- National Institutes of Health West Coast Metabolomics Center, University of California, Davis, California; Department of Chemistry, University of California, Davis, California
| | - Gregory Bryam
- National Institutes of Health West Coast Metabolomics Center, University of California, Davis, California
| | - Oliver Fiehn
- National Institutes of Health West Coast Metabolomics Center, University of California, Davis, California
| | - Lirui Wang
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - E-Hu Liu
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Ruth T Yu
- Gene Expression Laboratory, Salk Institute for Biological Studies, San Diego, California
| | - Michael Downes
- Gene Expression Laboratory, Salk Institute for Biological Studies, San Diego, California
| | - Ronald M Evans
- Gene Expression Laboratory, Salk Institute for Biological Studies, San Diego, California
| | | | | | - David A Brenner
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Lars Bode
- Department of Pediatrics and Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence, University of California San Diego, La Jolla, California
| | - Xuegong Fan
- Department of Infectious Diseases, Xiangya Hospital, Central South University and Key Laboratory of Viral Hepatitis, Hunan, Changsha, China
| | - Karsten Zengler
- Department of Pediatrics, University of California San Diego, La Jolla, California; Department of Bioengineering, University of California San Diego, La Jolla, California
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, California; Department of Medicine, VA San Diego Healthcare System, San Diego, California.
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15
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Bruellman R, Llorente C. A Perspective Of Intestinal Immune-Microbiome Interactions In Alcohol-Associated Liver Disease. Int J Biol Sci 2021; 17:307-327. [PMID: 33390852 PMCID: PMC7757023 DOI: 10.7150/ijbs.53589] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/13/2020] [Indexed: 02/07/2023] Open
Abstract
Uncovering the intricacies of the gut microbiome and how it interacts with the host immune system has opened up pathways in the search for the treatment of disease conditions. Alcohol-associated liver disease is a major cause of death worldwide. Research has shed light on the breakdown of the protective gut barriers, translocation of gut microbes to the liver and inflammatory immune response to microbes all contributing to alcohol-associated liver disease. This knowledge has opened up avenues for alternative therapies to alleviate alcohol-associated liver disease based on the interaction of the commensal gut microbiome as a key player in the regulation of the immune response. This review describes the relevance of the intestinal immune system, the gut microbiota, and specialized and non-specialized intestinal cells in the regulation of intestinal homeostasis. It also reflects how these components are altered during alcohol-associated liver disease and discusses new approaches for potential future therapies in alcohol-associated liver disease.
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Affiliation(s)
- Ryan Bruellman
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
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16
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De la Serna E, Camprodon-Boadas P, Ilzarbe D, Sugranyes G, Baeza I, Moreno D, Díaz-Caneja CM, Rosa-Justicia M, Llorente C, Ayora M, Borras R, Torrent C, Bernardo M, Castro-Fornieles J. Neuropsychological development in the child and adolescent offspring of patients diagnosed with schizophrenia or bipolar disorder: A two-year follow-up comparative study. Prog Neuropsychopharmacol Biol Psychiatry 2020; 103:109972. [PMID: 32454164 DOI: 10.1016/j.pnpbp.2020.109972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023]
Abstract
UNLABELLED There has been growing scientific evidence in recent years that schizophrenia and bipolar disorder share clinical, cognitive, neuroimaging and genetic characteristics. This overlap might also be present in their offspring, who have an increased risk of developing both disorders. Comparing the characteristics of these samples may have important implications for understanding etiological processes. This study aimed to assess the development of cognitive functions over two years in a sample of child and adolescent offspring of patients diagnosed with schizophrenia (SZoff) or bipolar disorder (BDoff), comparing them with a community control group (CCoff). METHODS 90 BDoff, 41 SZoff and 107 CCoff aged between 6 and 17 years were included at baseline. At the two-year follow-up, 84.9% of the sample was re-assessed (78 BDoff, 32 SZoff and 92 CCoff). All subjects were assessed with a comprehensive neuropsychological test battery at baseline and at the two-year follow-up to evaluate: intelligence quotient, working memory, processing speed, verbal memory and learning, visual memory, executive functions and sustained attention. RESULTS Processing speed, verbal memory and executive functions showed different developmental patterns among the SZoff, BDoff and CCoff groups. The SZoff group maintained baseline performances in the three variables over time, while the BDoff group presented improved processing speed and executive functioning and the CCoff group showed improvements in verbal memory and executive functions at follow-up. CONCLUSIONS These findings suggest that the development of some cognitive functions might differ between child and adolescent SZoff and BDoff, indicating different trajectories during neurodevelopment.
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Affiliation(s)
- E De la Serna
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain.
| | - P Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain
| | - D Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Universitair Medisch Centrum Utrecht, Utrecht, the Netherlands; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | - G Sugranyes
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | - I Baeza
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Spain
| | - D Moreno
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - C M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - M Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | - C Llorente
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - M Ayora
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - R Borras
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | - C Torrent
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
| | - M Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
| | - J Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona 2017SGR881, Spain; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Spain
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17
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Zhou R, Llorente C, Cao J, Gao B, Duan Y, Jiang L, Wang Y, Kumar V, Stärkel P, Bode L, Fan X, Schnabl B. Deficiency of Intestinal α1-2-Fucosylation Exacerbates Ethanol-Induced Liver Disease in Mice. Alcohol Clin Exp Res 2020; 44:1842-1851. [PMID: 32628772 PMCID: PMC7808344 DOI: 10.1111/acer.14405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/09/2020] [Accepted: 06/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fucosyltransferase 2 (Fut2)-mediated intestinal α1-2-fucosylation is important in maintaining a symbiotic host-microbiota relationship and can protect against several pathogens. Intestinal dysbiosis is an important factor for the progression of experimental ethanol (EtOH)-induced liver disease, but the role of Fut2 in modulating the intestinal glycocalyx during alcohol-associated liver disease is unknown. We investigated the role of Fut2-mediated intestinal α1-2-fucosylation for the development of alcohol-associated liver disease. METHODS Immunohistochemistry staining was applied to evaluate α1-2-fucosylation in duodenal biopsies from patients with alcohol use disorder. Wild-type (WT) and Fut2-deficient littermate mice were subjected to Lieber-DeCarli models of chronic EtOH administration and the chronic-binge EtOH diet (NIAAA model). RESULTS Intestinal α1-2-fucosylation was down-regulated in patients with alcohol use disorder. Lack of α1-2-fucosylation in Fut2-deficient mice exacerbates chronic EtOH-induced liver injury, steatosis, and inflammation without affecting EtOH metabolism. Dietary supplementation of the α1-2-fucosylated glycan 2'-fucosyllactose (2'-FL) ameliorates EtOH-induced liver disease in Fut2-deficient mice in the NIAAA model. Despite no direct effects on growth of Enterococcus faecalis in vitro, intestinal α1-2-fucosylation reduces colonization of cytolysin-positive E. faecalis in the intestine of EtOH-fed mice. CONCLUSIONS Intestinal α1-2-fucosylation acts as a host-protective mechanism against EtOH-induced liver disease. 2'-FL is an oligosaccharide naturally present in human milk that could be considered as therapeutic agent for alcohol-associated liver disease.
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Affiliation(s)
- Rongrong Zhou
- Department of Infectious Diseases, Xiangya Hospital, Central South University, and Key Laboratory of Viral Hepatitis, Hunan, Changsha, China
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Jinling Cao
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- College of Food Science and Engineering, Shanxi Agricultural University, Shanxi, Taigu, China
| | - Bei Gao
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Lu Jiang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Yanhan Wang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Vipin Kumar
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Peter Stärkel
- St Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Lars Bode
- Department of Pediatrics and Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California San Diego, La Jolla, CA, USA
| | - Xuegong Fan
- Department of Infectious Diseases, Xiangya Hospital, Central South University, and Key Laboratory of Viral Hepatitis, Hunan, Changsha, China
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
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18
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López-Higes R, Rubio-Valdehita S, Sánchez-Beato A, Galindo M, Mecha PR, García Cid S, Llorente C. Propiedades psicométricas y datos normativos de la prueba ECCO_Senior: un instrumento para evaluar la comprensión gramatical en adultos mayores. RLOG 2020. [DOI: 10.5209/rlog.66147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
El test ECCO_Senior se diseñó para evaluar la comprensión de oraciones en adultos mayores. Es una prueba corta y de fácil aplicación, que se ha empleado en distintos estudios previos. En el estudio participaron 670 personas, de 50 a 85 años de edad, que cumplían criterios de inclusión relativos al estatus cognitivo general, el estado de ánimo y porcentaje mínimo de aciertos en el test. Además de los test de cribado (MEC y GDS-15) y un cuestionario socio-demográfico, se aplicó a todos los participantes el test ECCO_Senior con el que se pueden obtener distintos índices (generales y específicos). Además de comprobar si existen diferencias entre los grupos según la edad y el nivel educativo, se evaluaron las propiedades psicométricas del test, incluyendo evidencias de validez en las que se probó la bondad de ajuste de tres modelos estructurales que sirven para identificar los índices que explican un mayor porcentaje de la varianza del constructo (comprensión de oraciones). Se ofrecen normas interpretativas del test por edad y nivel de estudios en los Apéndices. Los resultados indican que el test permite evaluar la comprensión de oraciones con una fiabilidad adecuada y es sensible a las dificultades que puede experimentar un adulto al realizar esta tarea. Los tres modelos muestran un buen ajuste y permiten concluir que las oraciones no ajustadas al orden sintáctico canónico y los distractores léxicos (si se considera el tipo de ítem) serían los mejores indicadores en términos del porcentaje de la varianza del constructo que explican.
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19
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Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, Hoekstra PJ, Coghill D, Schulze UME, Dittmann RW, Buitelaar JK, Castro-Fornieles J, Lievesley K, Santosh P, Arango C. Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry 2020; 29:759-776. [PMID: 30684089 PMCID: PMC7305074 DOI: 10.1007/s00787-018-01270-9] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022]
Abstract
Suicidality in childhood and adolescence is of increasing concern. The aim of this paper was to review the published literature identifying key psychosocial risk factors for suicidality in the paediatric population. A systematic two-step search was carried out following the PRISMA statement guidelines, using the terms 'suicidality, suicide, and self-harm' combined with terms 'infant, child, adolescent' according to the US National Library of Medicine and the National Institutes of Health classification of ages. Forty-four studies were included in the qualitative synthesis. The review identified three main factors that appear to increase the risk of suicidality: psychological factors (depression, anxiety, previous suicide attempt, drug and alcohol use, and other comorbid psychiatric disorders); stressful life events (family problems and peer conflicts); and personality traits (such as neuroticism and impulsivity). The evidence highlights the complexity of suicidality and points towards an interaction of factors contributing to suicidal behaviour. More information is needed to understand the complex relationship between risk factors for suicidality. Prospective studies with adequate sample sizes are needed to investigate these multiple variables of risk concurrently and over time.
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Affiliation(s)
- J. J. Carballo
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - C. Llorente
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - L. Kehrmann
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - I. Flamarique
- grid.410458.c0000 0000 9635 9413Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain
| | - A. Zuddas
- grid.7763.50000 0004 1755 3242Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, and “A. Cao” Paediatric Hospital, “G. Brotzu” Hospital Trust, Cagliari University Hospital, Cagliari, Italy
| | - D. Purper-Ouakil
- grid.414352.5CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l’Enfant et de l’Adolescent, Montpellier, France
| | - P. J. Hoekstra
- grid.4494.d0000 0000 9558 4598Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - D. Coghill
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Psychiatry, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Melbourne, Australia ,grid.8241.f0000 0004 0397 2876Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - U. M. E. Schulze
- grid.6582.90000 0004 1936 9748Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - R. W. Dittmann
- grid.7700.00000 0001 2190 4373Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J. K. Buitelaar
- grid.10417.330000 0004 0444 9382Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - J. Castro-Fornieles
- grid.410458.c0000 0000 9635 9413Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain ,grid.418264.d0000 0004 1762 4012Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
| | - K. Lievesley
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK ,HealthTracker Ltd, Gillingham, Kent UK
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK. .,Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK. .,HealthTracker Ltd, Gillingham, Kent, UK.
| | - C. Arango
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
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20
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Duan Y, Llorente C, Lang S, Brandl K, Chu H, Jiang L, White RC, Clarke TH, Nguyen K, Torralba M, Shao Y, Liu J, Hernandez-Morales A, Lessor L, Rahman IR, Miyamoto Y, Ly M, Gao B, Sun W, Kiesel R, Hutmacher F, Lee S, Ventura-Cots M, Bosques-Padilla F, Verna EC, Abraldes JG, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross DL, Ho SB, Louvet A, Lucey MR, Mathurin P, Garcia-Tsao G, Bataller R, Tu XM, Eckmann L, van der Donk WA, Young R, Lawley TD, Stärkel P, Pride D, Fouts DE, Schnabl B. Bacteriophage targeting of gut bacterium attenuates alcoholic liver disease. Nature 2019; 575:505-511. [PMID: 31723265 PMCID: PMC6872939 DOI: 10.1038/s41586-019-1742-x] [Citation(s) in RCA: 429] [Impact Index Per Article: 85.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
Chronic liver disease due to alcohol use disorder contributes markedly to the global burden of disease and mortality1–3. Alcoholic hepatitis is a severe and life-threatening form of alcohol-associated liver disease. The gut microbiota promotes ethanol-induced liver disease in mice4, but little is known about microbial factors responsible for this process. We identified cytolysin, a two-subunit exotoxin secreted by Enterococcus faecalis (E. faecalis)5,6, to cause hepatocyte death and liver injury. Compared with controls, patients with alcoholic hepatitis have increased fecal numbers of E. faecalis. The presence of cytolysin-positive (cytolytic) E. faecalis correlated with liver disease severity and mortality in patients with alcoholic hepatitis. Using humanized mice colonized with bacteria from feces of patients with alcoholic hepatitis, we investigated the therapeutic effects of bacteriophages that target cytolytic E. faecalis. We found these phages to decrease cytolysin in the liver and abolish ethanol-induced liver disease in humanized mice. Our findings link cytolysin-positive E. faecalis with worse clinical outcomes and mortality in patients with alcoholic hepatitis. We show that bacteriophages can specifically target cytolytic E. faecalis, providing a method to precisely edit the intestinal microbiota. A prospective clinical trial with a larger cohort is required to validate human relevance of our findings and to test whether this new therapeutic approach is effective for patients with alcoholic hepatitis.
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Affiliation(s)
- Yi Duan
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sonja Lang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Katharina Brandl
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA
| | - Huikuan Chu
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Lu Jiang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | | | | | | | | | - Yan Shao
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
| | - Jinyuan Liu
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | | | - Lauren Lessor
- Center for Phage Technology, Texas A & M AgriLife Research and Texas A & M University, College Station, TX, USA
| | - Imran R Rahman
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yukiko Miyamoto
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Melissa Ly
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Bei Gao
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Weizhong Sun
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Roman Kiesel
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Felix Hutmacher
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Suhan Lee
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Meritxell Ventura-Cots
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh Liver Research Center, Pittsburgh, PA, USA
| | - Francisco Bosques-Padilla
- Hospital Universitario, Departamento de Gastroenterología, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Elizabeth C Verna
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Juan G Abraldes
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert S Brown
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, USA
| | - Victor Vargas
- Liver Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Jose Altamirano
- Liver Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Caballería
- Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.,Liver Unit, Hospital Clinic, Barcelona, Spain
| | - Debbie L Shawcross
- Liver Sciences, Department of Inflammation Biology, School of Infectious Diseases and Microbial Sciences, King's College London, London, UK
| | - Samuel B Ho
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Alexandre Louvet
- Service des Maladies de L'appareil Digestif et Unité INSERM, Hôpital Huriez, Lille, France
| | - Michael R Lucey
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Philippe Mathurin
- Service des Maladies de L'appareil Digestif et Unité INSERM, Hôpital Huriez, Lille, France
| | - Guadalupe Garcia-Tsao
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.,Section of Digestive Diseases, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ramon Bataller
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh Liver Research Center, Pittsburgh, PA, USA
| | - Xin M Tu
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Lars Eckmann
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Wilfred A van der Donk
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Howard Hughes Medical Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ry Young
- Department of Biochemistry and Biophysics, Texas A & M University, College Station, TX, USA.,Center for Phage Technology, Texas A & M AgriLife Research and Texas A & M University, College Station, TX, USA
| | - Trevor D Lawley
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
| | - Peter Stärkel
- St Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - David Pride
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Pathology, University of California San Diego, La Jolla, CA, USA.,Center for Innovative Phage Applications and Therapeutics, University of California San Diego, La Jolla, CA, USA
| | | | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA. .,Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA. .,Center for Innovative Phage Applications and Therapeutics, University of California San Diego, La Jolla, CA, USA.
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21
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Fernández-Conejo G, de la Peña E, Hernández V, Pérez-Fernández E, Llorente C. Transition from active surveillance to observation in prostate cancer patients older than 75 years. A long follow-up series. Actas Urol Esp 2019; 43:378-383. [PMID: 31171379 DOI: 10.1016/j.acuro.2018.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/06/2018] [Accepted: 10/07/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The world population is ageing, and life expectancy is increasing. This situation will have a great impact on the management of patients with prostate cancer, especially in those of low risk, susceptible to a conservative management under active surveillance (AS). Regarding these patients' profile, it is necessary to answer the following questions: ¿for how long to continue with the AS scheme?, ¿which tests will be required?, ¿is it possible to carry out a transition to observation with oncological safety? The objective of this work is to analyse those patients with prostatic cancer who have been in AS with 75 years of age or more and assess the safety of the observation in an AS series with a long follow-up. MATERIAL AND METHODS We analysed our prospective cohort of AS patients between the years 1999 and 2018,including those who had been in follow-up with 75 years or more. They were offered treatment with curative intent when there were progression criteria and transition to observation under the urologist's decision. Some intermediate risk patients were included in the analysis. Comorbidity changes were analysed with the Charlson comorbidity index at entry and exit of AS. The progression and mortality of the patients were studied according to the management they received. RESULTS From 347 AS patients, 90 patients fulfilled the afore mentioned criteria and 15 (16.7%) were intermediate risk. The median follow-up was 6.4 years and 73 (81.1%) had low comorbidity (Charlson<2).There were 40 (44.4%) patients who left AS, 17 (18.9%) of them went to observationand the rest, 21 (23.3%), received curative treatment. There was a significant difference in comorbidity, measured by the Charlson index, at entry and exit of AS (P<.05) among patients receiving active treatment and the ones submitted to observation.No case of cancer-specific death or progression was observed in the observation group. CONCLUSION The transition from an active surveillance management to observation of prostate cancer elderly patients, as well as the decision to carry out a treatment with curative intent, seems controversial. In our series, this transition in patients older than 75 years does not increase the oncological risk.
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Affiliation(s)
- G Fernández-Conejo
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - E de la Peña
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - V Hernández
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - C Llorente
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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22
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Calvente CJ, Tameda M, Johnson CD, del Pilar H, Lin YC, Adronikou N, De Mollerat Du Jeu X, Llorente C, Boyer J, Feldstein AE. Neutrophils contribute to spontaneous resolution of liver inflammation and fibrosis via microRNA-223. J Clin Invest 2019; 129:4091-4109. [PMID: 31295147 PMCID: PMC6763256 DOI: 10.1172/jci122258] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/03/2019] [Indexed: 02/06/2023] Open
Abstract
Persistent, unresolved inflammation in the liver represents a key trigger for hepatic injury and fibrosis in various liver diseases and is controlled by classically activated pro-inflammatory macrophages, while restorative macrophages of the liver are capable of reversing inflammation once the injury trigger ceases. Here we have identified a novel role for neutrophils as key contributors to resolving the inflammatory response in the liver. Using two models of liver inflammatory resolution, we found that mice undergoing neutrophil depletion during the resolution phase exhibited unresolved hepatic inflammation, activation of the fibrogenic machinery and early fibrosis. These findings were associated with an impairment of the phenotypic switch of pro-inflammatory macrophages into a restorative stage after removal of the cause of injury and an increased NLRP3 / miR-223 ratio. Mice with a deletion of the granulocyte specific miR-223 gene showed a similarly impaired resolution profile that could be reversed by restoring miR-223 levels using a miR-223 3p mimic or infusing neutrophils from wildtype animals. Collectively, our findings reveal a novel role for neutrophils in the liver as resolving effector cells that induce pro-inflammatory macrophages into a restorative phenotype, potentially via miR-223.
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Affiliation(s)
| | - Masahiko Tameda
- Department of Pediatrics, School of Medicine, UCSD, San Diego, California, USA
| | - Casey D. Johnson
- Department of Pediatrics, School of Medicine, UCSD, San Diego, California, USA
| | - Hana del Pilar
- Department of Pediatrics, School of Medicine, UCSD, San Diego, California, USA
| | - Yun Chin Lin
- Department of Pediatrics, School of Medicine, UCSD, San Diego, California, USA
| | | | | | - Cristina Llorente
- Department of Medicine, School of Medicine, UCSD, San Diego, California, USA
| | - Josh Boyer
- Department of Medicine, School of Medicine, UCSD, San Diego, California, USA
| | - Ariel E. Feldstein
- Department of Pediatrics, School of Medicine, UCSD, San Diego, California, USA
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23
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Hartmann P, Hochrath K, Horvath A, Chen P, Seebauer CT, Llorente C, Wang L, Alnouti Y, Fouts DE, Stärkel P, Loomba R, Coulter S, Liddle C, Yu RT, Ling L, Rossi SJ, DePaoli AM, Downes M, Evans RM, Brenner DA, Schnabl B. Modulation of the intestinal bile acid/farnesoid X receptor/fibroblast growth factor 15 axis improves alcoholic liver disease in mice. Hepatology 2018; 67:2150-2166. [PMID: 29159825 PMCID: PMC5962369 DOI: 10.1002/hep.29676] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 10/28/2017] [Accepted: 11/17/2017] [Indexed: 12/13/2022]
Abstract
UNLABELLED Alcoholic liver disease (ALD) is associated with changes in the intestinal microbiota. Functional consequences of alcohol-associated dysbiosis are largely unknown. The aim of this study was to identify a mechanism of how changes in the intestinal microbiota contribute to ALD. Metagenomic sequencing of intestinal contents demonstrated that chronic ethanol feeding in mice is associated with an over-representation of bacterial genomic DNA encoding choloylglycine hydrolase, which deconjugates bile acids in the intestine. Bile acid analysis confirmed an increased amount of unconjugated bile acids in the small intestine after ethanol administration. Mediated by a lower farnesoid X receptor (FXR) activity in enterocytes, lower fibroblast growth factor (FGF)-15 protein secretion was associated with increased hepatic cytochrome P450 enzyme (Cyp)-7a1 protein expression and circulating bile acid levels. Depletion of the commensal microbiota with nonabsorbable antibiotics attenuated hepatic Cyp7a1 expression and reduced ALD in mice, suggesting that increased bile acid synthesis is dependent on gut bacteria. To restore intestinal FXR activity, we used a pharmacological intervention with the intestine-restricted FXR agonist fexaramine, which protected mice from ethanol-induced liver injury. Whereas bile acid metabolism was only minimally altered, fexaramine treatment stabilized the gut barrier and significantly modulated hepatic genes involved in lipid metabolism. To link the beneficial metabolic effect to FGF15, a nontumorigenic FGF19 variant-a human FGF15 ortholog-was overexpressed in mice using adeno-associated viruses. FGF19 treatment showed similarly beneficial metabolic effects and ameliorated alcoholic steatohepatitis. CONCLUSION Taken together, alcohol-associated metagenomic changes result in alterations of bile acid profiles. Targeted interventions improve bile acid-FXR-FGF15 signaling by modulation of hepatic Cyp7a1 and lipid metabolism, and reduce ethanol-induced liver disease in mice. (Hepatology 2018;67:2150-2166).
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Affiliation(s)
- Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Katrin Hochrath
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Angela Horvath
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Gastroenterology and Hepatology, Medical University of Graz, Graz Austria
| | - Peng Chen
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Lirui Wang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Yazen Alnouti
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Peter Stärkel
- St. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Rohit Loomba
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sally Coulter
- Storr Liver Centre, Westmead Institute for Medical Research and Sydney Medical School, University of Sydney, Australia
| | - Christopher Liddle
- Storr Liver Centre, Westmead Institute for Medical Research and Sydney Medical School, University of Sydney, Australia
| | - Ruth T. Yu
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Lei Ling
- NGM Biopharmaceuticals, Inc., South San Francisco, CA, USA
| | | | | | - Michael Downes
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Ronald M. Evans
- Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA
- Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - David A. Brenner
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
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24
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Khanova E, Wu R, Wang W, Yan R, Chen Y, French SW, Llorente C, Pan SQ, Yang Q, Li Y, Lazaro R, Ansong C, Smith RD, Bataller R, Morgan T, Schnabl B, Tsukamoto H. Pyroptosis by caspase11/4-gasdermin-D pathway in alcoholic hepatitis in mice and patients. Hepatology 2018; 67:1737-1753. [PMID: 29108122 PMCID: PMC5906140 DOI: 10.1002/hep.29645] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/23/2017] [Accepted: 11/02/2017] [Indexed: 12/11/2022]
Abstract
UNLABELLED Alcoholic hepatitis (AH) continues to be a disease with high mortality and no efficacious medical treatment. Although severe AH is presented as acute on chronic liver failure, what underlies this transition from chronic alcoholic steatohepatitis (ASH) to AH is largely unknown. To address this question, unbiased RNA sequencing and proteomic analyses were performed on livers of the recently developed AH mouse model, which exhibits the shift to AH from chronic ASH upon weekly alcohol binge, and these results are compared to gene expression profiling data from AH patients. This cross-analysis has identified Casp11 (CASP4 in humans) as a commonly up-regulated gene known to be involved in the noncanonical inflammasome pathway. Immunoblotting confirms CASP11/4 activation in AH mice and patients, but not in chronic ASH mice and healthy human livers. Gasdermin-D (GSDMD), which induces pyroptosis (lytic cell death caused by bacterial infection) downstream of CASP11/4 activation, is also activated in AH livers in mice and patients. CASP11 deficiency reduces GSDMD activation, bacterial load in the liver, and severity of AH in the mouse model. Conversely, the deficiency of interleukin-18, the key antimicrobial cytokine, aggravates hepatic bacterial load, GSDMD activation, and AH. Furthermore, hepatocyte-specific expression of constitutively active GSDMD worsens hepatocellular lytic death and polymorphonuclear leukocyte inflammation. CONCLUSION These results implicate pyroptosis induced by the CASP11/4-GSDMD pathway in the pathogenesis of AH. (Hepatology 2018;67:1737-1753).
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Affiliation(s)
- Elena Khanova
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Raymond Wu
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Wen Wang
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Rui Yan
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Yibu Chen
- Bioinformatics Service, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | | | - Cristina Llorente
- Department of Medicine, University of California San Diego and VA San Diego Healthcare System, San Diego, California, USA
| | - Stephanie Q. Pan
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Qihong Yang
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Yuchang Li
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Raul Lazaro
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA
| | - Charles Ansong
- Pacific Northwest National Laboratory, Richland, WA 99352
| | | | - Ramon Bataller
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Timothy Morgan
- Gastroenterology Services, VA Long Beach Healthcare System, Long Beach, California, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego and VA San Diego Healthcare System, San Diego, California, USA
| | - Hidekazu Tsukamoto
- Southern California Research Center for ALPD and Cirrhosis and Department of Pathology, Los Angeles, California, USA,Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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25
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Parellada M, Pina-Camacho L, Moreno C, Aleman Y, Krebs MO, Desco M, Merchán-Naranjo J, Del Rey-Mejías A, Boada L, Llorente C, Moreno D, Arango C, Janssen J. Insular pathology in young people with high-functioning autism and first-episode psychosis. Psychol Med 2017; 47:2472-2482. [PMID: 28436341 DOI: 10.1017/s0033291717000988] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions. METHODS Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored. RESULTS Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = -0.28, p = 0.041) and left posterior (r = -0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of 'autistic-like' symptoms (r = -0.30, p = 0.028). CONCLUSIONS The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.
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Affiliation(s)
- M Parellada
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - L Pina-Camacho
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - C Moreno
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - Y Aleman
- Department of Experimental Medicine,Hospital General Universitario Gregorio Marañón,IiSGM, CIBERSAM,Ibiza 43, 28009 Madrid,Spain
| | - M-O Krebs
- INSERM, U894, "Psychophysiology of psychiatric disorders Lab," Center for psychiatry and neurosciences, University Paris Descartes, Sorbonne Paris Cité; Institut de Psychiatrie-GDR 3557; and Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne,Paris,France
| | - M Desco
- Department of Experimental Medicine,Hospital General Universitario Gregorio Marañón,IiSGM, CIBERSAM,Ibiza 43, 28009 Madrid,Spain
| | - J Merchán-Naranjo
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - A Del Rey-Mejías
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - L Boada
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - C Llorente
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - D Moreno
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - C Arango
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
| | - J Janssen
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain
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26
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Abstract
The liver plays a central role in clearing bacteria from the bloodstream. Two articles in this issue of Cell Host & Microbe (Broadley et al., 2016; Zeng et al., 2016) identify new mechanisms by which resident liver macrophages (Kupffer cells) rapidly capture bacteria from the blood and eliminate them, while still allowing for the induction of adaptive immunity.
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Affiliation(s)
- Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA.
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27
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Quirce S, Delgado J, Entrenas LM, Grande M, Llorente C, López Viña A, Martínez Moragón E, Mascarós E, Molina J, Olaguibel JM, Pérez de Llano LA, Perpiñá Tordera M, Quintano JA, Rodríguez M, Román-Rodriguez M, Sastre J, Trigueros JA, Valero AL, Zoni AC, Plaza V. Quality Indicators of Asthma Care Derived From the Spanish Guidelines for Asthma Management (GEMA 4.0): A Multidisciplinary Team Report. J Investig Allergol Clin Immunol 2017; 27:69-73. [PMID: 28211351 DOI: 10.18176/jiaci.0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Quirce
- Servicio de Alergología, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - J Delgado
- Unidad de Gestión Clínica de Alergología, Hospital Virgen Macarena, Sevilla, Spain
| | - L M Entrenas
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - M Grande
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, SERMAS, Madrid, Spain
| | - C Llorente
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, SERMAS, Madrid, Spain
| | - A López Viña
- Servicio de Neumología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - E Martínez Moragón
- Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - E Mascarós
- Medicina de Atención Primaria, Centro de Salud Fuente de San Luis, Valencia, Spain; Departamento de Salud, Hospital Dr. Peset, Valencia, Spain
| | - J Molina
- Medicina de Atención Primaria, EAP Francia, Fuenlabrada, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - L A Pérez de Llano
- Servicio de Neumología, Hospital Universitario Lucus Agusti, Lugo, Spain
| | - M Perpiñá Tordera
- Servicio de Neumología, Hospital Universitario Politécnico La Fe, Valencia, Spain
| | - J A Quintano
- Medicina de Atención Primaria, Lucena, Córdoba, Spain
| | - M Rodríguez
- Servicio de Alergología, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - M Román-Rodriguez
- Medicina de Atención Primaria, Centro de Salud Son Pisá, Instituto de Investigación de Palma de Mallorca (IdisPa), Palma de Mallorca, Spain
| | - J Sastre
- Servicio de Alergología, Fundación Jiménez Díaz, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
| | - J A Trigueros
- Medicina de Atención Primaria, Centro de Salud Menasalbas, Toledo, Spain
| | - A L Valero
- Servicio de Neumología, Intitut Clinic Respiratori, Hospital Clinic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - A C Zoni
- Área de Epidemiología, Subdirección de Promoción y Prevención de la Salud, Consejería de Salud de la Comunidad de Madrid, Madrid, Spain
| | - V Plaza
- Departmento of Medicina Respiratoria, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Departmento de Medicina, Barcelona, Spain
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28
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Yang AM, Inamine T, Hochrath K, Chen P, Wang L, Llorente C, Bluemel S, Hartmann P, Xu J, Koyama Y, Kisseleva T, Torralba MG, Moncera K, Beeri K, Chen CS, Freese K, Hellerbrand C, Lee SM, Hoffman HM, Mehal WZ, Garcia-Tsao G, Mutlu EA, Keshavarzian A, Brown GD, Ho SB, Bataller R, Stärkel P, Fouts DE, Schnabl B. Intestinal fungi contribute to development of alcoholic liver disease. J Clin Invest 2017; 127:2829-2841. [PMID: 28530644 DOI: 10.1172/jci90562] [Citation(s) in RCA: 295] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 03/30/2017] [Indexed: 12/14/2022] Open
Abstract
Chronic liver disease with cirrhosis is the 12th leading cause of death in the United States, and alcoholic liver disease accounts for approximately half of all cirrhosis deaths. Chronic alcohol consumption is associated with intestinal bacterial dysbiosis, yet we understand little about the contribution of intestinal fungi, or mycobiota, to alcoholic liver disease. Here we have demonstrated that chronic alcohol administration increases mycobiota populations and translocation of fungal β-glucan into systemic circulation in mice. Treating mice with antifungal agents reduced intestinal fungal overgrowth, decreased β-glucan translocation, and ameliorated ethanol-induced liver disease. Using bone marrow chimeric mice, we found that β-glucan induces liver inflammation via the C-type lectin-like receptor CLEC7A on Kupffer cells and possibly other bone marrow-derived cells. Subsequent increases in IL-1β expression and secretion contributed to hepatocyte damage and promoted development of ethanol-induced liver disease. We observed that alcohol-dependent patients displayed reduced intestinal fungal diversity and Candida overgrowth. Compared with healthy individuals and patients with non-alcohol-related cirrhosis, alcoholic cirrhosis patients had increased systemic exposure and immune response to mycobiota. Moreover, the levels of extraintestinal exposure and immune response correlated with mortality. Thus, chronic alcohol consumption is associated with an altered mycobiota and translocation of fungal products. Manipulating the intestinal mycobiome might be an effective strategy for attenuating alcohol-related liver disease.
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Affiliation(s)
- An-Ming Yang
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Internal Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Tatsuo Inamine
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Peng Chen
- Department of Medicine, UCSD, La Jolla, California, USA
| | - Lirui Wang
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
| | - Cristina Llorente
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
| | - Sena Bluemel
- Department of Medicine, UCSD, La Jolla, California, USA
| | | | - Jun Xu
- Department of Surgery, UCSD, La Jolla, California, USA
| | | | | | | | | | - Karen Beeri
- J. Craig Venter Institute, La Jolla, California, USA
| | - Chien-Sheng Chen
- Institute of Systems Biology and Bioinformatics, National Central University, Taoyuan City, Taiwan
| | - Kim Freese
- Institute of Biochemistry (Emil-Fischer Zentrum), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Claus Hellerbrand
- Institute of Biochemistry (Emil-Fischer Zentrum), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Serene Ml Lee
- Department of General, Visceral and Transplantation Surgery, Hospital of the LMU Munich, Munich, Germany
| | - Hal M Hoffman
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Pediatrics, UCSD, La Jolla, California, USA
| | - Wajahat Z Mehal
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.,Section of Digestive Diseases, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Guadalupe Garcia-Tsao
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.,Section of Digestive Diseases, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Ece A Mutlu
- Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Ali Keshavarzian
- Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Gordon D Brown
- Aberdeen Fungal Group, Medical Research Council Centre for Medical Mycology, University of Aberdeen, Aberdeen, United Kingdom
| | - Samuel B Ho
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
| | - Ramon Bataller
- Liver Center, Departments of Medicine and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Peter Stärkel
- Saint Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | | | - Bernd Schnabl
- Department of Medicine, UCSD, La Jolla, California, USA.,Department of Medicine, VA San Diego Healthcare System, San Diego, California, USA
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29
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Guijarro A, Hernández V, de la Morena JM, Jiménez-Valladolid I, Pérez-Fernández E, de la Peña E, Llorente C. Influence of the location and number of metastases in the survival of metastatic prostatic cancer patients. Actas Urol Esp 2017; 41:226-233. [PMID: 27773340 DOI: 10.1016/j.acuro.2016.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/25/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The prognosis of patients diagnosed with metastatic prostate cancer seems to be modulated by factors such as the number and site of metastases. Our objective is to evaluate survival outcomes according to the number and site of metastases in our series of metastatic patients over the last 15 years. MATERIALS AND METHODS A retrospective analysis was performed on patients diagnosed between 1998 and 2014. We analyzed overall survival and progression-free survival, depending on the number and location of metastases on patients with newly diagnosed metastatic prostate cancer. Other potential prognostic factors were also evaluated: age, clinical stage, PSA at diagnosis, Gleason, PSA nadir, time till PSA nadir and first-line or second-line treatment after progression. RESULTS We analyzed a series of 162 patients. The mean age was 72.7yr (SD: 8.5). The estimated median overall survival was 3.9 yr (95% CI 2.6-5.2). The overall survival in patients with only lymph node metastases was 7 yr (95% CI 4.1-9.7), 3.9 (95%CI 2.3-5.5) in patients with only bone metastases, 2.5 yr (95% CI 2-2.3) in lymph nodes and bone metastases, and 2.2 yr (95% CI 1.4-3) in patients with visceral metastases (P<.001). In multivariate analysis, the location of metastasesis significantly associated with overall survival and progression-free survival. The number of metastases showed no association with survival. CONCLUSIONS The site of metastases has a clear impact on both overall survival and progression-free survival. Patients with only lymph node involvement had a better prognosis. The number of metastases showed no significant impact on survival in our series.
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Affiliation(s)
- A Guijarro
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - V Hernández
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - J M de la Morena
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - I Jiménez-Valladolid
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - E Pérez-Fernández
- Unidad de investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - E de la Peña
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - C Llorente
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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30
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Llorente C, López B, Hernández V, Guijarro A, Pérez-Fernández E. Variability in complications and operative mortality after radical cystectomy in Spain. Actas Urol Esp 2017; 41:32-38. [PMID: 27543258 DOI: 10.1016/j.acuro.2016.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/04/2016] [Accepted: 06/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the literature, mortality for radical cystectomy (RC) varies between 2.3% and 7.5%. In Spain, there are no published general data on morbidity and mortality. OBJECTIVE To identify the complications and mortality of RC in Spain through an analysis of all procedures performed over a 3-year period and to study the geographic variability of these results. MATERIAL AND METHODS We identified patients who underwent RC in the Spanish National Health System between 2011 and 2013 based on the minimum basic data set. We analysed the complications and mortality during hospitalisation and at 30, 60 and 90 days. We compared these results in the various autonomous communities, adjusted them by age, Charlson score and sex and subsequently added the hospital size. RESULTS We studied 7999 patients who underwent RC in 197 hospitals of the Spanish National Health System. The mean age of the series was 67.2±9.8 years. The median stay was 15 days (IQR, 11-24). Some 47.2% of the patients had complications. The mean mortality in-hospital and at 30, 60 and 90 days was 4.7, 2.9, 5 and 6.2%, respectively. There was considerable variability in the mortality at 90 days among the communities (3.8-9.1%). When adjusting by the patient and hospital characteristics, there were still significant geographic variations (3.8-11.5%). CONCLUSIONS RC mortality in Spain at 90 days is similar to the rate in the literature. There are significant geographic variations unexplained by the characteristics of the patients or by those of the hospitals in which these operations were performed.
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Affiliation(s)
- C Llorente
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España.
| | - B López
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
| | - V Hernández
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
| | - A Guijarro
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
| | - E Pérez-Fernández
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
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Flamarique I, Santosh P, Zuddas A, Arango C, Purper-Ouakil D, Hoekstra PJ, Coghill D, Schulze U, Dittmann RW, Buitelaar JK, Lievesley K, Frongia R, Llorente C, Méndez I, Sala R, Fiori F, Castro-Fornieles J. Development and psychometric properties of the Suicidality: Treatment Occurring in Paediatrics (STOP) Suicidality Assessment Scale (STOP-SAS) in children and adolescents. BMC Pediatr 2016; 16:213. [PMID: 27964729 PMCID: PMC5155380 DOI: 10.1186/s12887-016-0751-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To create a self-reported, internet-based questionnaire for the assessment of suicide risk in children and adolescents. METHODS As part of the EU project 'Suicidality: Treatment Occurring in Paediatrics' (STOP project), we developed web-based Patient Reported Outcome Measures (PROMs) for children and adolescents and for proxy reports by parents and clinicians in order to assess suicidality. Based on a literature review, expert panels and focus groups of patients, we developed the items of the STOP Suicidality Assessment Scale (STOP-SAS) in Spanish and English, translated it into four more languages, and optimized it for web-based presentation using the HealthTrackerTM platform. Of the total 19 questions developed for the STOP-SAS, four questions that assess low-level suicidality were identified as screening questions (three of them for use with children, and all four for use with adolescents, parents and clinicians). A total of 395 adolescents, 110 children, 637 parents and 716 clinicians completed the questionnaire using the HealthTrackerTM, allowing us to evaluate the internal consistency and convergent validity of the STOP-SAS with the clinician-rated Columbia Suicide Severity Rating Scale (C-SSRS). Validity was also assessed with the receiver operating characteristic (ROC) area of the STOP-SAS with the C-SSRS. RESULTS The STOP-SAS comprises 19 items in its adolescent, parent, and clinician versions, and 14 items in its children's version. Good internal consistency was found for adolescents (Cronbach's alpha: 0.965), children (Cronbach's alpha: 0.922), parents (Cronbach's alpha: 0.951) and clinicians (Cronbach's alpha: 0.955) versions. A strong correlation was found between the STOP-SAS and the C-SSRS for adolescents (r:0.670), parents (r:0.548), clinicians (r:0.863) and children (r:0.654). The ROC area was good for clinicians' (0.917), adolescents' (0.834) and parents' (0.756) versions but only fair (0.683) for children's version. CONCLUSIONS The STOP-SAS is a comprehensive, web-based PROM developed on the HealthTrackerTM platform, and co-designed for use by adolescents, children, parents and clinicians. It allows the evaluation of aspects of suicidality and shows good reliability and validity.
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Affiliation(s)
- I Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari of Barcelona, Fundació Clínic per la Recerca Biomèdica, C/Villarroel, 170, Barcelona, 08036, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - P Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,Centre for Interventional Paediatric Psychopharmacology, South London and Maudsley NHS Foundation Trust, London, UK
| | - A Zuddas
- Department of Biomedical Sciences, Cagliari University Hospital, University of Cagliari, Cagliari, Italy
| | - C Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - D Purper-Ouakil
- CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, France.,INSERM U894-Team 1. Center of Psychiatry and Neurosciences, Paris, France
| | - P J Hoekstra
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - U Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - R W Dittmann
- Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - K Lievesley
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - R Frongia
- Department of Biomedical Sciences, Cagliari University Hospital, University of Cagliari, Cagliari, Italy
| | - C Llorente
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - I Méndez
- Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari of Barcelona, Fundació Clínic per la Recerca Biomèdica, C/Villarroel, 170, Barcelona, 08036, Spain
| | - R Sala
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - F Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - J Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari of Barcelona, Fundació Clínic per la Recerca Biomèdica, C/Villarroel, 170, Barcelona, 08036, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain
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Wang L, Fouts DE, Stärkel P, Hartmann P, Chen P, Llorente C, DePew J, Moncera K, Ho SB, Brenner DA, Hooper LV, Schnabl B. Intestinal REG3 Lectins Protect against Alcoholic Steatohepatitis by Reducing Mucosa-Associated Microbiota and Preventing Bacterial Translocation. Cell Host Microbe 2016; 19:227-39. [PMID: 26867181 DOI: 10.1016/j.chom.2016.01.003] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/14/2015] [Accepted: 01/13/2016] [Indexed: 02/07/2023]
Abstract
Approximately half of all deaths from liver cirrhosis, the tenth leading cause of mortality in the United States, are related to alcohol use. Chronic alcohol consumption is accompanied by intestinal dysbiosis and bacterial overgrowth, yet little is known about the factors that alter the microbial composition or their contribution to liver disease. We previously associated chronic alcohol consumption with lower intestinal levels of the antimicrobial-regenerating islet-derived (REG)-3 lectins. Here, we demonstrate that intestinal deficiency in REG3B or REG3G increases numbers of mucosa-associated bacteria and enhances bacterial translocation to the mesenteric lymph nodes and liver, promoting the progression of ethanol-induced fatty liver disease toward steatohepatitis. Overexpression of Reg3g in intestinal epithelial cells restricts bacterial colonization of mucosal surfaces, reduces bacterial translocation, and protects mice from alcohol-induced steatohepatitis. Thus, alcohol appears to impair control of the mucosa-associated microbiota, and subsequent breach of the mucosal barrier facilitates progression of alcoholic liver disease.
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Affiliation(s)
- Lirui Wang
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | | | - Peter Stärkel
- St. Luc University Hospital, Université Catholique de Louvain, Brussels 1200, Belgium
| | - Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Peng Chen
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | | | | | - Samuel B Ho
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - David A Brenner
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Lora V Hooper
- Howard Hughes Medical Institute; Department of Immunology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA 92161, USA.
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Inamine T, Yang AM, Wang L, Lee KC, Llorente C, Schnabl B. Genetic Loss of Immunoglobulin A Does Not Influence Development of Alcoholic Steatohepatitis in Mice. Alcohol Clin Exp Res 2016; 40:2604-2613. [PMID: 27739086 DOI: 10.1111/acer.13239] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 09/12/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Chronic alcohol abuse is associated with intestinal dysbiosis and bacterial translocation. Translocated commensal bacteria contribute to alcoholic liver disease. Secretory immunoglobulin A (IgA) in the intestine binds bacteria and prevents bacterial translocation. METHODS To investigate the functional role of IgA in ethanol (EtOH)-induced liver disease in mice, we subjected wild type (WT) and IgA-deficient littermate mice to Lieber-DeCarli models of chronic EtOH administration and the model of chronic and binge EtOH feeding (the NIAAA model). RESULTS Chronic EtOH feeding increased systemic levels of IgA, while fecal IgA was reduced in C57BL/6 WT mice. WT and Iga-/- littermate mice showed similar liver injury, steatosis, and inflammation following 4 weeks of EtOH feeding or chronic and binge EtOH feeding. IgA deficiency did not affect intestinal absorption or hepatic metabolism of EtOH. Pretreatment with ampicillin elevated intestinal IgA in WT littermate mice. Despite increased intestinal IgA, WT littermate mice exhibited a similar degree of liver disease compared with Iga-/- mice after 7 weeks of EtOH feeding. Interestingly, bacterial translocation to mesenteric lymph nodes was increased in Iga-/- mice fed an isocaloric diet, but was the same after EtOH feeding relative to WT littermate mice. The absence of intestinal IgA was associated with increased intestinal and plasma IgM in Iga-/- mice after EtOH feeding. CONCLUSIONS Our findings indicate that absence of IgA does not affect the development of alcoholic liver disease in mice. Loss of intestinal IgA is compensated by increased levels of intestinal IgM, which likely limits bacterial translocation after chronic EtOH administration.
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Affiliation(s)
- Tatsuo Inamine
- Department of Medicine, University of California San Diego, La Jolla, California.,Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - An-Ming Yang
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Lirui Wang
- Department of Medicine, University of California San Diego, La Jolla, California.,Department of Medicine, VA San Diego Healthcare System, San Diego, California
| | - Kuei-Chuan Lee
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, California.,Department of Medicine, VA San Diego Healthcare System, San Diego, California
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, California.,Department of Medicine, VA San Diego Healthcare System, San Diego, California
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Pozo C, Galarza I, Martinez de Hurtado J, Guijarro A, Llorente C. PS-07-003 Penile prosthesis implant in a neophallus. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Guijarro A, Reguero L, Hernández V, de la Morena JM, De la Peña E, López B, Fernández B, Parrilla C, Pérez-Fernández E, Alemany I, Llorente C. Diagnostic yield and complications of extended lymphadenectomy versus limited lymphadenectomy combined with radical prostatectomy. Actas Urol Esp 2016; 40:75-81. [PMID: 26359707 DOI: 10.1016/j.acuro.2015.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 08/02/2015] [Accepted: 08/03/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lymphadenectomy for prostate cancer (PC) is the most reliable procedure for detecting lymphatic metastases. The optimal extension of this procedure is still a topic of debate. OBJECTIVE To analyse the diagnostic performance and complications of extended lymphadenectomy (ELD) and limited lymphadenectomy (LLD) in a series of patients with high-risk PC who underwent radical prostatectomy (RP). MATERIAL AND METHODS A retrospective study was conducted on patients with high d'Amico risk who underwent RP with lymphadenectomy between 1999 and 2014. A comparative analysis was performed of the diagnostic capacity of lymphatic metastases of ELD and LLD and of postoperative complications at 90 days. RESULTS Ninety-three patients were analysed, 20 (21.5%) and 73 (78.5%) of whom underwent ELD and LLD, respectively. The mean age of the series was 65.26 years (SD, 5.51). The median follow-up was 1.51 (0.61-2.29) years in the ELD group and 5.94 (3.61-9.10) in the LLD group. The median number of nodes obtained was 13 (9-23) in the ELD group compared with 5 (2-8) in the LLD group (p <.001). The percentages of patients with positive nodes in the ELD and LLD groups were 35% and 5.47%, respectively (p <.001). The overall complication rate at 90 days was 35.5% (33 patients). In the ELD group, 12 patients (60%) had complications, compared with 21 patients (28.8%) in the LLD group (p=.016), with no significant differences in severity according to the Clavien scale (p=.73). CONCLUSIONS In our series, the detection of metastatic nodes was significantly greater with ELD. ELD increases the number of complications, with no differences compared with LLD in severity according to the modified Clavien scale.
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Affiliation(s)
- A Guijarro
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.
| | - L Reguero
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - V Hernández
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - J M de la Morena
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - E De la Peña
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - B López
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - B Fernández
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - C Parrilla
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - I Alemany
- Servicio Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - C Llorente
- Servicio Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
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36
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Hartmann P, Seebauer CT, Mazagova M, Horvath A, Wang L, Llorente C, Varki NM, Brandl K, Ho SB, Schnabl B. Deficiency of intestinal mucin-2 protects mice from diet-induced fatty liver disease and obesity. Am J Physiol Gastrointest Liver Physiol 2016; 310:G310-22. [PMID: 26702135 PMCID: PMC4773827 DOI: 10.1152/ajpgi.00094.2015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 12/01/2015] [Indexed: 02/08/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) and obesity are characterized by altered gut microbiota, inflammation, and gut barrier dysfunction. Here, we investigated the role of mucin-2 (Muc2) as the major component of the intestinal mucus layer in the development of fatty liver disease and obesity. We studied experimental fatty liver disease and obesity induced by feeding wild-type and Muc2-knockout mice a high-fat diet (HFD) for 16 wk. Muc2 deficiency protected mice from HFD-induced fatty liver disease and obesity. Compared with wild-type mice, after a 16-wk HFD, Muc2-knockout mice exhibited better glucose homeostasis, reduced inflammation, and upregulated expression of genes involved in lipolysis and fatty acid β-oxidation in white adipose tissue. Compared with wild-type mice that were fed the HFD as well, Muc2-knockout mice also displayed higher intestinal and plasma levels of IL-22 and higher intestinal levels of the IL-22 target genes Reg3b and Reg3g. Our findings indicate that absence of the intestinal mucus layer activates the mucosal immune system. Higher IL-22 levels protect mice from diet-induced features of the metabolic syndrome.
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Affiliation(s)
- Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Caroline T Seebauer
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Magdalena Mazagova
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Angela Horvath
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Lirui Wang
- Department of Medicine, University of California San Diego, La Jolla, California; Department of Medicine, VA San Diego Healthcare System, San Diego, California
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, California; Department of Medicine, VA San Diego Healthcare System, San Diego, California
| | - Nissi M Varki
- Department of Medicine, University of California San Diego, La Jolla, California; Department of Pathology, University of California San Diego, La Jolla, California; and
| | - Katharina Brandl
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California
| | - Samuel B Ho
- Department of Medicine, University of California San Diego, La Jolla, California; Department of Medicine, VA San Diego Healthcare System, San Diego, California
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, California; Department of Medicine, VA San Diego Healthcare System, San Diego, California;
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Fernández Conejo G, De la Peña E, Sola I, Stanescu RI, Llorente C. Diagnosis challenge of atypical spindle cells neoplasm of the spermatic cord. ARCH ESP UROL 2016; 69:38-40. [PMID: 26856737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To report an unusual case of softtissue neoplasm and to review the literature on this type of tumour. METHODS We report an accidentally found tumour closely related to the spermatic cord that was diagnosed in a 70 year-old man when he was being operated on for an inguinal hernia repair. RESULTS After thorough analysis by experienced pathologists it was not possible to determine the nature of the tumour that was removed at surgery. CONCLUSIONS Soft tissues neoplasms of the spermatic cord may occur in an unusual way and they may be a real challenge to diagnose.
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Affiliation(s)
- G Fernández Conejo
- Departments of Urology and Pathology. Hospital Universitario Fundación Alcorcón. Madrid. Spain
| | - E De la Peña
- Departments of Urology and Pathology. Hospital Universitario Fundación Alcorcón. Madrid. Spain
| | - I Sola
- Departments of Urology and Pathology. Hospital Universitario Fundación Alcorcón. Madrid. Spain
| | - R I Stanescu
- Departments of Urology and Pathology. Hospital Universitario Fundación Alcorcón. Madrid. Spain
| | - C Llorente
- Departments of Urology and Pathology. Hospital Universitario Fundación Alcorcón. Madrid. Spain
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Wang L, Llorente C, Hartmann P, Yang AM, Chen P, Schnabl B. Methods to determine intestinal permeability and bacterial translocation during liver disease. J Immunol Methods 2015; 421:44-53. [PMID: 25595554 PMCID: PMC4451427 DOI: 10.1016/j.jim.2014.12.015] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 12/04/2014] [Indexed: 02/08/2023]
Abstract
Liver disease is often times associated with increased intestinal permeability. A disruption of the gut barrier allows microbial products and viable bacteria to translocate from the intestinal lumen to extraintestinal organs. The majority of the venous blood from the intestinal tract is drained into the portal circulation, which is part of the dual hepatic blood supply. The liver is therefore the first organ in the body to encounter not only absorbed nutrients, but also gut-derived bacteria and pathogen associated molecular patterns (PAMPs). Chronic exposure to increased levels of PAMPs has been linked to disease progression during early stages and to infectious complications during late stages of liver disease (cirrhosis). It is therefore important to assess and monitor gut barrier dysfunction during hepatic disease. We review methods to assess intestinal barrier disruption and discuss advantages and disadvantages. We will in particular focus on methods that we have used to measure increased intestinal permeability and bacterial translocation in experimental liver disease models.
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Affiliation(s)
- Lirui Wang
- Department of Medicine, University of California San Diego, La Jolla, CA, United States; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, United States
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, CA, United States; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, United States
| | - Phillipp Hartmann
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - An-Ming Yang
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Peng Chen
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, CA, United States; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, United States.
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Abstract
The leaky gut hypothesis links translocating microbial products with the onset and progression of liver disease, and for a long time was considered one of its major contributors. However, a more detailed picture of the intestinal microbiota contributing to liver disease started to evolve. The gut is colonized by trillions of microbes that aid in digestion, modulate immune response, and generate a variety of products that result from microbial metabolic activities. These products together with host-bacteria interactions influence both normal physiology and disease susceptibility. A disruption of the symbiosis between microbiota and host is known as dysbiosis and can have profound effects on health. Qualitative changes such as increased proportions of harmful bacteria and reduced levels of beneficial bacteria, and also quantitative changes in the total amount of bacteria (overgrowth) have been associated with liver disease. Understanding the link between the pathophysiology of liver diseases and compositional and functional changes of the microbiota will help in the design of innovative therapies. In this review, we focus on factors resulting in dysbiosis, and discuss how dysbiosis can disrupt intestinal homeostasis and contribute to liver disease.
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Key Words
- dysbiosis
- leaky gut
- alcoholic liver disease
- nash
- nafld
- cirrhosis
- microbiome
- pamps
- ald, alcoholic liver disease
- amp, antimicrobial peptides and proteins
- fiaf, fasting-induced adipocyte factor
- hfd, high-fat diet
- ibd, inflammatory bowel disease
- il, interleukin
- lcfa, long-chain fatty acid
- lps, lipopolysaccharide
- nafld, nonalcoholic fatty liver disease
- nash, nonalcoholic steatohepatitis
- nlrp, nucleotide-binding domain and leucine rich repeat-containing protein
- nod2, nucleotide-binding oligomerization domain 2
- pamps, pathogen-associated molecular patterns
- reg3, regenerating islet-derived 3
- tlr, toll-like receptor
- tnf, tumor necrosis factor
- tnfr, tumor necrosis factor receptor
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Affiliation(s)
| | - Bernd Schnabl
- Correspondence Address correspondence to: Bernd Schnabl, MD, Department of Medicine, University of California–San Diego, Biomedical Research Facility 2 (BRF2), Room 4A22, 9500 Gilman Drive, MC0063, La Jolla, California 92093. fax: (858) 822-5370.
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Díaz FJ, de la Peña E, Hernández V, López B, de La Morena JM, Martín MD, Jiménez-Valladolid I, Llorente C. Optimization of an early discharge program after laparoscopic radical prostatectomy. Actas Urol Esp 2014; 38:355-60. [PMID: 24529540 DOI: 10.1016/j.acuro.2013.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 11/14/2013] [Accepted: 12/14/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the safety of hospital discharge 24 hours after laparoscopic radical prostatectomy and to identify possible factors associated with longer hospital stays. MATERIAL AND METHODS Retrospective study of patients diagnosed with localized prostate cancer underwent to laparoscopic radical prostatectomy consecutively between May of 2007 and December of 2010. Those patients who met the following requirements were discharged in less than 24 hours: absence of complications, drainage debit minor than 50 cc, normal oral tolerance, no significant bladder haematuria and good functional recovery. Logistic regression analysis was conducted in order to assess the possible associated variables with longer hospital stays. RESULTS A total of 266 patients were analysed. The follow-up median was 34 months. Eighty patients (30.1%) were discharged in less than 24 hours. Average stay (SD) of all series was 2.9 days (3.08). Solely HTA, neurovascular bundles sparing and the development of lymphadenectomy were statistically significant between both groups in univariate analysis (discharge<24 hours vs. discharge>24 hours). In multivariate analysis, only HTA (OR=1.98 [CI 95%:1.13-3.47], P=.016) and lymphadenectomy performance (OR=2.56 [CI 95%:1.18-5.56] P=.017) were independent predictive variables of hospital stays longer than 24 hours. CONCLUSIONS Early hospital discharge of patients underwent to LRP is feasible and safe. In our series, the lymphadenectomy performance and the HTA were associated factors to longer hospital stay.
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Affiliation(s)
- F J Díaz
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.
| | - E de la Peña
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - V Hernández
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - B López
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - J M de La Morena
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - M D Martín
- Servicio de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Madrid, España
| | | | - C Llorente
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
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Ramos M, Boada L, Moreno C, Llorente C, Romo J, Parellada M. Attitude and risk of substance use in adolescents diagnosed with Asperger syndrome. Drug Alcohol Depend 2013; 133:535-40. [PMID: 23962420 DOI: 10.1016/j.drugalcdep.2013.07.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 07/16/2013] [Accepted: 07/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Adolescence is a stage of development with increased risk of drug use. Individual personality traits are among those factors that influence the onset of substance use in adolescence and its psychiatric comorbidity. Little research has been done on the comorbidity between substance abuse risk and Asperger syndrome, and none specifically in adolescence. The objective of this study is to assess the risk of drug use by adolescents with Asperger syndrome and compare it with that risk in control subjects. A secondary objective was to analyze the personality factors that may be associated with substance use in the same two groups. METHODS We used three self-administered questionnaires, one for drug risk assessment (FRIDA) and the other two for personality trait assessment (MACI and SSS-V). RESULTS Adolescents diagnosed with Asperger syndrome are at less risk for drug use derived from family and access to drugs factors. Subjects with Asperger syndrome did score higher on introversive, inhibited, doleful, and borderline tendency prototypes than healthy controls, and scored lower on all sensation-seeking traits. Being male, a diagnosis of Asperger syndrome, and unruly, introversive, and sensation-seeking traits were all independently associated with the risk of drug abuse. CONCLUSIONS Both identified personality factors and other variables associated with the Asperger syndrome contribute to the low risk of drug abuse observed in this population. Exploring protective factors for drug use in these subjects may prove useful for interventions with adolescents at risk for consumption.
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Affiliation(s)
- M Ramos
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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Hernández V, Blázquez C, de la Peña E, Pérez-Fernández E, Díaz F, Llorente C. Active surveillance in low-risk prostate cancer. Patient acceptance and results. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.acuroe.2013.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Argañaraz MQ, Ribotta S, Folquer M, Zelaya E, Llorente C, Ramallo-López J, Benítez G, Rubert A, Gassa L, Vela M, Salvarezza R. The chemistry and structure of nickel–tungsten coatings obtained by pulse galvanostatic electrodeposition. Electrochim Acta 2012. [DOI: 10.1016/j.electacta.2012.03.163] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kang K, Pereda M, Canafoglia M, Bilmes P, Llorente C, Bonetto R. Uncertainty studies of topographical measurements on steel surface corrosion by 3D scanning electron microscopy. Micron 2012; 43:387-95. [DOI: 10.1016/j.micron.2011.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 10/04/2011] [Accepted: 10/04/2011] [Indexed: 10/16/2022]
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Pereda M, Kang K, Bonetto R, Llorente C, Bilmes P, Gervasi C. Impact of Surface Treatment on the Corrosion Resistance of ASTM F138-F139 Stainless Steel for Biomedical Applications. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.mspro.2012.06.060] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hernández V, De La Peña E, Martin MD, Blázquez C, Diaz FJ, Llorente C. External validation and applicability of the EORTC risk tables for non-muscle-invasive bladder cancer. World J Urol 2010; 29:409-14. [PMID: 21190023 DOI: 10.1007/s00345-010-0635-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Accepted: 12/09/2010] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To perform an external validation of the EORTC risk tables and to evaluate their applicability in the patients of our institution by comparing the actual risk of recurrence and progression in our series to those obtained through the application of the EORTC tables. METHODS Retrospective study, based on a prospective cohort of 417 patients in follow-up with primary TaT1 bladder tumors, operated on in our center between 1998 and 2008 and collected in our database. Risk scores were assigned depending on the tumor characteristics to divide our series into four risk groups according to these ratings. An analysis of survival was carried out to calculate the probability of recurrence by the method of Kaplan-Meier. RESULTS A total of 417 patients with a median follow-up of 59 months were studied. The overall recurrence and progression rates of our series were 25.95% (21.97-30.49) and 4.86% (3.16-7.43) at 1 year and 53.46% (48.06-59.05) and 8.43% (5.95-11.86) at 5 years, respectively. When we compare our rates of recurrence and progression by groups with the corresponding values from Sylvester's publication, an overlapping of the confidence intervals between both populations is detected. CONCLUSIONS In terms of the applicability of the EORTC risk tables in our patients' population, we conclude that these tables predict accurately the clinical course of patients with NMIBC. Due to the sample size of our study, we can only validate the recurrence model of the EORTC tables.
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Affiliation(s)
- Virginia Hernández
- Department of Urology, Hospital Universitario Fundación de Alcorcón, C/Budapest 1, 28911, Alcorcón, Madrid, Spain.
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Alvarez M, Hernández V, Amaruch N, Llorente C. [Bladder carcinosarcoma. Two case reports and a literature review]. Actas Urol Esp 2010; 34:736-737. [PMID: 20800042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Alvarez M, Hernández V, Amaruch N, Llorente C. Carcinosarcoma vesical. Presentación de dos casos y revisión de la literatura. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2010.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Martínez-Sánchez P, Fuentes B, Medina-Báez J, Grande M, Llorente C, Parrilla P, Fuster A, Gil A, Sánchez M, Olguín C, García-Caballero J, Díez-Tejedor E. [Development of an acute stroke care pathway in a hospital with stroke unit]. Neurologia 2010; 25:17-26. [PMID: 20388457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION Care pathways (CP) are tools for standardizing the management of patient in certain diseases with a predictable course, and they have demonstrated usefulness in clinical practice. In-hospital stroke CP have been implemented in departments of Neurology, General Medicine or Rehabilitation, however there are few studies developing an integrated CP in hospitals with an acute Stroke Unit (SU). The aim is to develop a CP capable of organizing and homogenizing the stroke assistance, and integrating the quality standards, in a hospital with an Acute Stroke Unit (SU). METHODS Members of the Neurology, Rehabilitation, Emergency and Preventive Medicine departments established a schedule of nine fortnightly meetings. Several documents that compound the CP were elaborated following the FOCUS-PDCA model, according with the scientific evidence and the in force clinical guides. RESULTS The following documents were elaborated: scientific-technical framework which integrates all processes; information document for patient/relatives on-admission; nurses protocols (social risk, disphagya, falling down risk and pressure ulcers); stroke rehabilitation guidelines for staff; treatment, care and monitoring sheets; recommendations at discharge for patient/relatives; stroke rehabilitation guidelines for patient/relatives; specific didactic units for patient/relatives; patient/relatives satisfaction survey; and quality standard document. CONCLUSIONS A stroke CP in a hospital with SU potentially promotes a more organized and efficient stroke care, as well as improve the patient/relatives satisfaction.
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Affiliation(s)
- P Martínez-Sánchez
- Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
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