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Efe C, Lammert C, Taşçılar K, Dhanasekaran R, Ebik B, Higuera-de la Tijera F, Calışkan AR, Peralta M, Gerussi A, Massoumi H, Catana AM, Purnak T, Rigamonti C, Aldana AJG, Khakoo N, Nazal L, Frager S, Demir N, Irak K, Melekoğlu-Ellik Z, Kacmaz H, Balaban Y, Atay K, Eren F, Alvares-da-Silva MR, Cristoferi L, Urzua Á, Eşkazan T, Magro B, Snijders R, Barutçu S, Lytvyak E, Zazueta GM, Demirezer-Bolat A, Aydın M, Heurgue-Berlot A, De Martin E, Ekin N, Yıldırım S, Yavuz A, Bıyık M, Narro GC, Kıyıcı M, Akyıldız M, Kahramanoğlu-Aksoy E, Vincent M, Carr RM, Günşar F, Reyes EC, Harputluoğlu M, Aloman C, Gatselis NK, Üstündağ Y, Brahm J, Vargas NCE, Güzelbulut F, Garcia SR, Aguirre J, Anders M, Ratusnu N, Hatemi I, Mendizabal M, Floreani A, Fagiuoli S, Silva M, Idilman R, Satapathy SK, Silveira M, Drenth JPH, Dalekos GN, N Assis D, Björnsson E, Boyer JL, Yoshida EM, Invernizzi P, Levy C, Montano-Loza AJ, Schiano TD, Ridruejo E, Wahlin S. Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis. Liver Int 2022; 42:607-614. [PMID: 34846800 DOI: 10.1111/liv.15121] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 09/02/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH). PATIENTS AND METHODS Data of AIH patients with laboratory confirmed COVID-19 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID-19 were compared to patients who were not on AIH medication. The clinical courses of COVID-19 were classified as (i)-no hospitalization, (ii)-hospitalization without oxygen supplementation, (iii)-hospitalization with oxygen supplementation by nasal cannula or mask, (iv)-intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v)-ICU admission with invasive mechanical ventilation or (vi)-death and analysed using ordinal logistic regression. RESULTS We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17-85) years. At the onset of COVID-19, 234 patients (92.1%) were on treatment with glucocorticoids (n = 156), thiopurines (n = 151), mycophenolate mofetil (n = 22) or tacrolimus (n = 16), alone or in combinations. Overall, 94 (37%) patients were hospitalized and 18 (7.1%) patients died. Use of systemic glucocorticoids (adjusted odds ratio [aOR] 4.73, 95% CI 1.12-25.89) and thiopurines (aOR 4.78, 95% CI 1.33-23.50) for AIH was associated with worse COVID-19 severity, after adjusting for age-sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76-20.56) and tacrolimus (aOR 4.09, 95% CI 0.69-27.00) were also associated with more severe COVID-19 courses in a smaller subset of treated patients. CONCLUSION Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID-19 was significantly associated with COVID-19 severity in patients with AIH.
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Affiliation(s)
- Cumali Efe
- Department of Gastroenterology, Harran University Hospital, Şanlıurfa, Turkey
| | - Craig Lammert
- Department of Medicine Indiana, University School of Medicine Indianapolis, Indianapolis, Indiana, USA
| | - Koray Taşçılar
- Department of Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Renumathy Dhanasekaran
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California, USA
| | - Berat Ebik
- Department of Gastroenterology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey
| | | | - Ali R Calışkan
- Department of Gastroenterology, Adıyaman University, Adıyaman, Turkey
| | - Mirta Peralta
- Hepatology Section, Hospital Francisco J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.,Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina
| | - Alessio Gerussi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Hatef Massoumi
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Andreea M Catana
- Division of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Tugrul Purnak
- Division of Gastroenterology, Hepatology and Nutrition, McGovern Medical School, Houston, Texas, USA
| | - Cristina Rigamonti
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy.,Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Andres J G Aldana
- Gastroenterology and Hepatology Unit, Fundación Santa Fe de Bogotá y universidad de Los Andes, Bogotá, Colombia
| | - Nidah Khakoo
- Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Leyla Nazal
- Gastroenterology and Hepatology Unit, Clínica Las Condes, Santiago de Chile, Chile
| | - Shalom Frager
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Nurhan Demir
- Department of Gastroenterology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Kader Irak
- Department of Gastroenterology, SBU Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | | | - Hüseyin Kacmaz
- Department of Gastroenterology, Adıyaman University, Adıyaman, Turkey
| | - Yasemin Balaban
- Department of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kadri Atay
- Departmant of Gastroenterology, Mardin State Hospital, Mardin, Turkey
| | - Fatih Eren
- Departmant of Gastroenterology, Ordu State Hospital, Ordu, Turkey
| | - Mario R Alvares-da-Silva
- Gastroenterology and Hepatology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura Cristoferi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Álvaro Urzua
- Gastroenterology and Hepatology Unit. Hospital Clínico, Universidad de Chile, Santiago de Chile, Chile
| | - Tuğçe Eşkazan
- Department of Gastroenterology, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Bianca Magro
- Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII-Bergamo, Bergamo, Italy
| | - Romee Snijders
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.,European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Nijmegen, The Netherlands
| | - Sezgin Barutçu
- Department of Gastroenterology, University of Gaziantep Medical Faculty, Gaziantep, Turkey
| | - Ellina Lytvyak
- Division of Gastroenterology and Liver Unit, University of Alberta, Edmonton, Alberta, Canada
| | - Godolfino M Zazueta
- Gastroenterology Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | | | - Mesut Aydın
- School of Medicine, Department of Gastroenterology, Van Yuzuncu Yil University, Van, Turkey
| | | | - Eleonora De Martin
- Centre Hepato-Biliaire, Hôpital Paul-Brousse, FHU Hepatinov, INSERM Unit UMR 1193, Univ Paris-Saclay, Gif-sur-Yvette, France
| | - Nazım Ekin
- Department of Gastroenterology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey
| | - Sümeyra Yıldırım
- Department of Gastroenterology, Erciyes Hospital, Kayseri, Turkey
| | - Ahmet Yavuz
- Division of Gastroenterology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Murat Bıyık
- Division of Gastroenterology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Graciela C Narro
- Gastroenterology Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | - Murat Kıyıcı
- Department of Gastroenterology, Medical Faculty, Uludag University, Bursa, Turkey
| | - Murat Akyıldız
- Department of Gastroenterology, Koc University School of Medicine, Istanbul, Turkey
| | | | - Maria Vincent
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, Manhasset, NY, USA
| | - Rotonya M Carr
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Fulya Günşar
- Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey
| | - Eira C Reyes
- Hepatology Unit. Hospital Militar Central de México, Ciudad de México, México
| | - Murat Harputluoğlu
- Department of Gastroenterology, Inönü University School of Medicine, Malatya, Turkey
| | - Costica Aloman
- Section of Hepatology, Rush University Medical Center, Chicago, Illinois, USA
| | - Nikolaos K Gatselis
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - Yücel Üstündağ
- Department of Gastroenterology, Bulent Ecevit University of Medicine, Zonguldak, Turkey
| | - Javier Brahm
- Gastroenterology Unit, Clínica Las Condes, Santiago, Chile
| | - Nataly C E Vargas
- Hepatology Unit Hospital Nacional Almanzor Aguinaga Asenjo, Chiclayo, Perú
| | - Fatih Güzelbulut
- Department of Gastroenterology, Haydarpaşa Numune Education and Research Hospital, İstanbul, Turkey
| | - Sandro R Garcia
- Gastroenterology Unit, Hospital Víctor Lazarte Echegaray, Trujillo, Perú
| | - Jonathan Aguirre
- Hepatology Unit, Hospital Ángeles Pedregal, Ciudad de México, México
| | - Margarita Anders
- Hepatology and Liver Transplant Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Natalia Ratusnu
- Hepatology Unit, Hospital Regional de Ushuaia, Ushuaia, Argentina
| | - Ibrahim Hatemi
- Department of Gastroenterology, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Manuel Mendizabal
- Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina.,Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Annarosa Floreani
- Scientific Consultant IRCCS Negrar, Verona, Italy.,Senior Scholar, University of Padova, Padova, Italy
| | - Stefano Fagiuoli
- Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII-Bergamo, Bergamo, Italy
| | - Marcelo Silva
- Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina.,Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Medical Faculty, Ankara, Turkey
| | - Sanjaya K Satapathy
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, Manhasset, NY, USA
| | - Marina Silveira
- Department of Medicine, Section of Digestive Diseases Yale School of Medicine, New Haven, Connecticut, USA
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.,European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Nijmegen, The Netherlands
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - David N Assis
- Department of Medicine, Section of Digestive Diseases Yale School of Medicine, New Haven, Connecticut, USA
| | - Einar Björnsson
- Department of Internal Medicine, Section of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland
| | - James L Boyer
- Department of Medicine, Section of Digestive Diseases Yale School of Medicine, New Haven, Connecticut, USA
| | - Eric M Yoshida
- Division of Gastroenterology, University of British Columbia and Vancouver General Hospital, Vancouver, Canada
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Cynthia Levy
- Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Aldo J Montano-Loza
- Division of Gastroenterology and Liver Unit, University of Alberta, Edmonton, Alberta, Canada
| | - Thomas D Schiano
- Division of Liver Diseases, The Mount Sinai Medical Center, New York, New York, USA
| | - Ezequiel Ridruejo
- Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina.,Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina.,Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas, CEMIC, Ciudad Autónoma de Buenos Aires, Argentina
| | - Staffan Wahlin
- Hepatology Division, Department of Upper GI Diseases, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Bayram M, Irak K, Cifci S, Koksal AR, Kazezoglu C, Acar Z, Ozarı HO, Alkim H. The effectiveness of small heterodimer partner and FGF 19 levels in prediction of perinatal morbidity in intrahepatic cholestasis of pregnancy. J OBSTET GYNAECOL 2022; 42:1174-1178. [DOI: 10.1080/01443615.2022.2028275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mehmet Bayram
- Department of Gastroenterology, Health Sciences University Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Kader Irak
- Department of Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Sami Cifci
- Department of Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ali Riza Koksal
- Department of Gastroenterology & Hepatology, Tulane University of Medicine, New Orleans, LA, USA
| | - Cemal Kazezoglu
- Department of Biochemistry, Health Sciences University Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Zuat Acar
- Department of Perinatology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Halil Onur Ozarı
- Department of Gastroenterology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Alkim
- Department of Gastroenterology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Bülbül H, Irak K, Berk S, Ulusoy Y, Ayer M. SPONTANEOUS GASTROSPLENIC FISTULA: AN UNUSUAL PRESENTATION OF DIFFUSE LARGE B CELL LYMPHOMA. Gastroenterol Nurs 2022; 45:63-66. [PMID: 35020633 DOI: 10.1097/sga.0000000000000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Hale Bülbül
- Hale Bülbül, MD, is a hematologist at Tepecik Training and Research Hospital, İzmir, Turkey
- Kader Irak, MD, is a gastroenterologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Selin Berk, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Yusuf Ulusoy, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Mesut Ayer, MD, is an associate professor and the head of Hematology Department at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Kader Irak
- Hale Bülbül, MD, is a hematologist at Tepecik Training and Research Hospital, İzmir, Turkey
- Kader Irak, MD, is a gastroenterologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Selin Berk, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Yusuf Ulusoy, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Mesut Ayer, MD, is an associate professor and the head of Hematology Department at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Selin Berk
- Hale Bülbül, MD, is a hematologist at Tepecik Training and Research Hospital, İzmir, Turkey
- Kader Irak, MD, is a gastroenterologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Selin Berk, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Yusuf Ulusoy, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Mesut Ayer, MD, is an associate professor and the head of Hematology Department at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Yusuf Ulusoy
- Hale Bülbül, MD, is a hematologist at Tepecik Training and Research Hospital, İzmir, Turkey
- Kader Irak, MD, is a gastroenterologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Selin Berk, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Yusuf Ulusoy, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Mesut Ayer, MD, is an associate professor and the head of Hematology Department at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Mesut Ayer
- Hale Bülbül, MD, is a hematologist at Tepecik Training and Research Hospital, İzmir, Turkey
- Kader Irak, MD, is a gastroenterologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Selin Berk, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Yusuf Ulusoy, MD, is a hematologist at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
- Mesut Ayer, MD, is an associate professor and the head of Hematology Department at Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
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Yavuz E, Irak K, Çelik ÖY, Bolacali M, Ergiden Y, Gürgöze S. Determination of the Relationship of Serum Amino Acid Profile with Sex and Body Weight in Healthy Geese by Liquid Chromatography-Tandem Mass Spectrometry. Braz J Poult Sci 2022. [DOI: 10.1590/1806-9061-2021-1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- E Yavuz
- International Center for Livestock Research and Training, Turkey
| | | | | | | | - Y Ergiden
- International Center for Livestock Research and Training, Turkey
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Abstract
Crohn's disease (CD) is characterized by malfunction of immune-regulatory mechanisms with disturbed intestinal mucosal homeostasis and increased activation of mucosal immune cells, leading to abnormal secretion of numerous pro- and anti-inflammatory mediators. MCP2/CCL8 is produced by intestinal epithelial cells and macrophages, and is a critical regulator of mucosal inflammation. NLRC4 is expressed in phagocytes and intestinal epithelial cells and is involved in intestinal homeostasis and host defense. However, no study to date has assessed the circulating levels of NLRC4 and MCP2/CCL8 in patients with CD. The study was aimed to investigate the serum levels of MCP2/CCL8 and NLRC4 in patients with active CD. Sixty-nine patients with active CD and 60 healthy participants were included in the study. Serum levels of NLRC4 and MCP2/CCL8 were determined using an enzyme-linked immunosorbent assay. The median serum NLRC4 levels were lower in the patient group than in the controls (71.02 (range, 46.59-85.51) pg/mL vs. 99.43 (range 83.52-137.79) pg/mL) (P < 0.001). The median serum levels of MCP2/CCL8 were decreased in patients with CD (28.68 (range, 20.16-46.0) pg/mL) compared with the controls (59.96 (range, 40.22-105.59) pg/mL) (P < 0.001). Cut-off points of NLRC4 (<81 pg/mL) and MCP2/CCL8 (<40 pg/mL) showed high sensitivity and specificity for identifying active CD. In conclusion, this is the first study to examine circulating levels of MCP2/CCL8 and NLRC4 in patients with active CD. Our results suggest that serum NLRC4 and MCP2/CCL8 levels may be involved in the pathogenesis of CD and may have a protective effect on intestinal homeostasis and inflammation. Serum levels of MCP2/CCL8 and NLRC4 could be used as a diagnostic tool and therapeutic target for CD.
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Affiliation(s)
- Kader Irak
- Department of Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
- * E-mail:
| | - Mehmet Bayram
- Department of Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Sami Cifci
- Department of Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Gulsen Sener
- Department of Biochemistry, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
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Irak K, Bayram M, Cifci S, Acar Z, Kazezoglu C, Ogutmen Koc D, Arslan O. Evaluation of G-Protein-Coupled Bile Acid Receptor 1 (TGR5) Levels in Intrahepatic Cholestasis of Pregnancy. Cureus 2021; 13:e19654. [PMID: 34976450 PMCID: PMC8678695 DOI: 10.7759/cureus.19654] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 11/28/2022] Open
Abstract
Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-protein-coupled bile acid receptor 1 (TGR5) agonists might be beneficial in ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.
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Affiliation(s)
- Kader Irak
- Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR
| | - Mehmet Bayram
- Gastroenterology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Sami Cifci
- Gastroenterology, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR
| | - Zuat Acar
- Gynecology and Obstetrics, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Cemal Kazezoglu
- Biochemistry, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR
| | - Deniz Ogutmen Koc
- Gastroenterology, University of Health Sciences, Gaziosmanpasa Training and Research Hospital, Istanbul, TUR
| | - Oyku Arslan
- Hematology, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR
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Bolacali M, Irak K, Tufan T, Küçük M. Effects of gender and dietary date palm extract on performance, carcass traits, and antioxidant status of Japanese quail. S AFR J ANIM SCI 2021. [DOI: 10.4314/sajas.v51i3.13] [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: 11/17/2022]
Abstract
This research examined effects of gender and dietary inclusion of date palm extract (DPE) on growth, carcass characteristics, oxidative status and serum characteristics of Japanese quail. One thousand chicks were allocated to five replicates of treatment and gender groups composed of 20 chicks. The treatments were a basal diet and four groups augmented with 0.25%, 0.50%, 0.75%, and 1.00% DPE. The interaction of gender and treatment was significant for bodyweight (BW) at 42 days, average daily bodyweight gain (BWG), feed intake (FI), weights of most carcass components, and the serum profile. Females had better performance to 42 days than males (P <0.05). In addition, females had higher hot and cold carcass weights, breast percentage, liver percentage, intestine percentage, total protein, albumin, triglyceride (TRIG), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress indexes (OSIs) (P <0.001). Males had higher percentages of hot carcass, cold carcass and heart, and their levels of cholesterol (CHOL), high-density lipoprotein (HDL), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values were greater than females (P <0.001). Birds fed 0.50% DPE grew faster, were more efficient, and had heavier live and carcass weights at 42 days than those fed the basal diet. However, treatment effects and their interaction with gender on growth, feed intake and the serum profile were unremarkable compared to the gender main effect. Dietary augmentation with 0.50% DPE might enhance the performance of quail between 14 and 42 days old.
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Efe C, Dhanasekaran R, Lammert C, Ebik B, Higuera‐de la Tijera F, Aloman C, Rıza Calışkan A, Peralta M, Gerussi A, Massoumi H, Catana AM, Torgutalp M, Purnak T, Rigamonti C, Gomez Aldana AJ, Khakoo N, Kacmaz H, Nazal L, Frager S, Demir N, Irak K, Ellik ZM, Balaban Y, Atay K, Eren F, Cristoferi L, Batıbay E, Urzua Á, Snijders R, Kıyıcı M, Akyıldız M, Ekin N, Carr RM, Harputluoğlu M, Hatemi I, Mendizabal M, Silva M, Idilman R, Silveira M, Drenth JP, Assis DN, Björnsson E, Boyer JL, Invernizzi P, Levy C, Schiano TD, Ridruejo E, Wahlin S. Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study. Hepatology 2021; 73:2099-2109. [PMID: 33713486 PMCID: PMC8250536 DOI: 10.1002/hep.31797] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Data regarding outcome of COVID-19 in patients with autoimmune hepatitis (AIH) are lacking. APPROACH AND RESULTS We performed a retrospective study on patients with AIH and COVID-19 from 34 centers in Europe and the Americas. We analyzed factors associated with severe COVID-19 outcomes, defined as the need for mechanical ventilation, intensive care admission, and/or death. The outcomes of patients with AIH were compared to a propensity score-matched cohort of patients without AIH but with chronic liver diseases (CLD) and COVID-19. The frequency and clinical significance of new-onset liver injury (alanine aminotransferase > 2 × the upper limit of normal) during COVID-19 was also evaluated. We included 110 patients with AIH (80% female) with a median age of 49 (range, 18-85) years at COVID-19 diagnosis. New-onset liver injury was observed in 37.1% (33/89) of the patients. Use of antivirals was associated with liver injury (P = 0.041; OR, 3.36; 95% CI, 1.05-10.78), while continued immunosuppression during COVID-19 was associated with a lower rate of liver injury (P = 0.009; OR, 0.26; 95% CI, 0.09-0.71). The rates of severe COVID-19 (15.5% versus 20.2%, P = 0.231) and all-cause mortality (10% versus 11.5%, P = 0.852) were not different between AIH and non-AIH CLD. Cirrhosis was an independent predictor of severe COVID-19 in patients with AIH (P < 0.001; OR, 17.46; 95% CI, 4.22-72.13). Continuation of immunosuppression or presence of liver injury during COVID-19 was not associated with severe COVID-19. CONCLUSIONS This international, multicenter study reveals that patients with AIH were not at risk for worse outcomes with COVID-19 than other causes of CLD. Cirrhosis was the strongest predictor for severe COVID-19 in patients with AIH. Maintenance of immunosuppression during COVID-19 was not associated with increased risk for severe COVID-19 but did lower the risk for new-onset liver injury during COVID-19.
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Demiröz H, Bayram M, Irak K, Yıldırım Ö, Kumbasar A, Tabak Ö. Comparison of Liver Histopathology with Non-invasive Inflammation Markers as Neutrophil-lymphocyte Ratio, Platelet-lymphocyte Ratio and Mean Platelet Volume in Chronic Hepatitis B Patients. Egypt J Immunol 2021. [DOI: 10.4274/vhd.galenos.2021.2020-11-3] [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: 12/01/2022]
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Kadirogullari P, Yalcin Bahat P, Topbas Selcuki F, Irak K, Seckin KD. Ovarian reserve assessment in crohn patients of reproductive age. Ginekol Pol 2021; 92:550-555. [PMID: 33844252 DOI: 10.5603/gp.a2020.0170] [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: 07/23/2020] [Revised: 02/23/2021] [Accepted: 10/05/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Crohn's disease (CD) is a repeating bowel disease characterized by remission and exacerbation periods. The disease mostly affects adults of reproductive age. Women with desires to conceive are concerned about the effects of CD on their fertility. To demonstrate the relationship between ovarian reserve and CD anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and ovarian volüme were evaluated. MATERIAL AND METHODS The prospective case-controlled study was conducted at a tertiary referral center in Istanbul between March-August 2019. Ovarian functions were evaluated in 50 patients with CD and in 95 healthy women. Serum gonadotropin and AMH levels were determined. AFCs and ovarian volumes were calculated for all subjects. RESULTS AMH levels were significantly lower in CD patients (2.1 ± 0.8) compared to the control group (3.3 ± 0.9) (P = 0.001). Serum AMH levels were significantly lower in patients with active CD (2.1 ± 0.6) than the CD patients in remission (2.6 ± 0.8) (p = 0.002). Ovarian volumes and AFC values were significantly lower in both ovaries in CD patients compared to the controls (p < 0.05). CONCLUSIONS AMH levels, ovarian volume and AFC counts, and thus ovarian reserve was shown to be decreased in CD patients of reproductive age compared to healthy control subjects. Because possible effects of inflammatory damage may be seen in newly diagnosed female CD patients who desire to have a child, we believe that CD patients should be comprehensively assessed for ovarian reserve.
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Affiliation(s)
- Pinar Kadirogullari
- Department of Obstetrics and Gynecology, Acıbadem University Atakent Hospital, Istanbul, Turkey.
| | - Pinar Yalcin Bahat
- Department of Obstetrics and Gynecology, Health Sciences University Kanuni Sultan Suleyman Suam, Istanbul, Turkey
| | - Fitnat Topbas Selcuki
- Department of Obstetrics and Gynecology, Health Sciences University Kanuni Sultan Suleyman Suam, Istanbul, Turkey
| | - Kader Irak
- Department of Gastroenterology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Kerem Doga Seckin
- Department of Obstetrics and Gynecology, Health Sciences University Kanuni Sultan Suleyman Suam, Istanbul, Turkey
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Değertekin B, Demir M, Akarca US, Kani HT, Üçbilek E, Yıldırım E, Güzelbulut F, Balkan A, Vatansever S, Danış N, Demircan M, Soylu A, Yaras S, Kartal A, Kefeli A, Gündüz F, Yalçın K, Erarslan E, Aladağ M, Harputluoğlu M, Özakyol A, Temel T, Akarsu M, Sümer H, Akın M, Albayrak B, Sen İ, Alkım H, Uyanıkoğlu A, Irak K, Öztaşkın S, Uğurlu ÇB, Güneş Ş, Gürel S, Nuriyev K, İnci İ, Kaçar S, Dinçer D, Doğanay L, Göktürk HS, Mert A, Coşar AM, Dursun H, Atalay R, Akbulut S, Balkan Y, Koklu H, Şimşek H, Özdoğan O, Çoban M, Poturoğlu Ş, Ayyıldız T, Yapalı S, Günsar F, Akdoğan M, Özenirler S, Akyıldız M, Sezgin O, Özdoğan O, Kaymakoğlu S, Beşışık F, Karasu Z, İdilman R. Real-world efficacy and safety of Ledipasvir + Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir ± Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience. Turk J Gastroenterol 2020; 31:883-893. [PMID: 33626001 PMCID: PMC7928249 DOI: 10.5152/tjg.2020.20696] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/09/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND/AIMS This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population. MATERIAL AND METHODS A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)±ribavirin (RBV) orombitasvir/paritaprevir/ritonavir±dasabuvir (PrOD)±RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed. RESULTS SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90±54.60 U/L to 17.00±14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51±4.54 to 7.32±3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0±16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%). CONCLUSION LDV/SOF or PrOD±RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.
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Affiliation(s)
- Bülent Değertekin
- Division of Gastroenterology and Hepatology, Acibadem Mehmet Ali Aydinlar University School of Medicine, İstanbul, Turkey
| | - Mehmet Demir
- Division of Gastroenterology Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Ulus S. Akarca
- Division of Gastroenterology and Hepatology, Ege University School of Medicine, İzmir, Turkey
| | - Haluk Tarık Kani
- Division of Gastroenterology and Hepatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Enver Üçbilek
- Division of Gastroenterology, Mersin University School of Medicine, Mersin, Turkey
| | - Emre Yıldırım
- Division of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Fatih Güzelbulut
- Division of Gastroenterology, Haydarpasa Numune Training and Research Hospital, İstan-bul, Turkey
| | - Ayhan Balkan
- Division of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Sezgin Vatansever
- Division of Gastroenterology, Kâtip Celebi University, İzmir, Turkey
| | - Nilay Danış
- Division of Gastroenterology and Hepatology, Ege University School of Medicine, İzmir, Turkey
| | - Melek Demircan
- Division of Gastroenterology, Eskisehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Aliye Soylu
- Division of Gastroenterology, Health Sciences University Bakırkoy Hospital, İstanbul, Turkey
| | - Serkan Yaras
- Division of Gastroenterology, Mersin University School of Medicine, Mersin, Turkey
| | - Aysun Kartal
- Division of Gastroenterology and Hepatology, Ankara University School of Medicine, Ankara, Turkey
| | - Ayşe Kefeli
- Division of Gastroenterology, Tokat Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Feyza Gündüz
- Division of Gastroenterology and Hepatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Kendal Yalçın
- Division of Gastroenterology and Hepatology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Elife Erarslan
- Division of Gastroenterology, Dışkapı Trainining and Research Hospital, Ankara, Turkey
| | - Murat Aladağ
- Division of Gastroenterology and Hepatology, İnonu University School of Medicine, Malatya, Turkey
| | - Murat Harputluoğlu
- Division of Gastroenterology and Hepatology, İnonu University School of Medicine, Malatya, Turkey
| | - Ayşegül Özakyol
- Division of Gastroenterology, Eskisehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Tuncer Temel
- Division of Gastroenterology, Eskisehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Mesut Akarsu
- Division of Gastroenterology and Hepatology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Hale Sümer
- Division of Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Mete Akın
- Division of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bülent Albayrak
- Division of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - İlker Sen
- Division of Gastroenterology, Health Sciences University, Şişli Etfal Hospital, İstanbul, Turkey
| | - Hüseyin Alkım
- Division of Gastroenterology, Health Sciences University, Şişli Etfal Hospital, İstanbul, Turkey
| | - Ahmet Uyanıkoğlu
- Division of Gastroenterology, Harran University School of Medicine, Urfa, Turkey
| | - Kader Irak
- Division of Gastroenterology, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey
| | - Sinem Öztaşkın
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - Çağrı Burak Uğurlu
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - Şevkican Güneş
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - Selim Gürel
- Division of Gastroenterology and Hepatology, Uludag University School of Medicine, Bursa, Turkey
| | - Kenan Nuriyev
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - İsmail İnci
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - Sabite Kaçar
- Division of Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Dinç Dinçer
- Division of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Levent Doğanay
- Division of Gastroenterology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | | | - Ali Mert
- Division of Infectious Diseases, Istanbul Medipol University School of Medicine, İstanbul Turkey
| | - Arif Mansur Coşar
- Division of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Hakan Dursun
- Division of Gastroenterology, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Roni Atalay
- Division of Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Sabiye Akbulut
- Division of Gastroenterology, Kartal Kosuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey
| | - Yasemin Balkan
- Division of İnfectious Diseases, Gaziantep 25 Aralık Government Hospital, Gaziantep, Turkey
| | - Hayrettin Koklu
- Division of Gastroenterology and Hepatology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Halis Şimşek
- Division of Gastroenterology and Hepatology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Osman Özdoğan
- Division of Gastroenterology, Mersin University School of Medicine, Mersin, Turkey
| | - Mehmet Çoban
- Division of Gastroenterology, Ufuk University School of Medicine, Ankara, Turkey
| | - Şule Poturoğlu
- Division of Gastroenterology, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Talat Ayyıldız
- Division of Gastroenterology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Suna Yapalı
- Division of Gastroenterology and Hepatology, Acibadem Mehmet Ali Aydinlar University School of Medicine, İstanbul, Turkey
| | - Fulya Günsar
- Division of Gastroenterology and Hepatology, Ege University School of Medicine, İzmir, Turkey
| | - Meral Akdoğan
- Division of Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Seren Özenirler
- Division of Gastroenterology, Gazi University School of Medicine, Ankara, Turkey
| | - Murat Akyıldız
- Department of Gastroenterology, Organ Transplantation Center, Memorial Atasehir Hospital, İstanbul, Turkey
| | - Orhan Sezgin
- Division of Gastroenterology, Mersin University School of Medicine, Mersin, Turkey
| | - Osman Özdoğan
- Division of Gastroenterology and Hepatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Sabahattin Kaymakoğlu
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - Fatih Beşışık
- Division of Gastroenterology and Hepatology, İstanbul University School of Medicine, İstanbul Turkey
| | - Zeki Karasu
- Division of Gastroenterology and Hepatology, Ege University School of Medicine, İzmir, Turkey
| | - Ramazan İdilman
- Division of Gastroenterology and Hepatology, Ankara University School of Medicine, Ankara, Turkey
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Cifci S, Irak K, Bayram M, Ekmen N, Kazezoglu C, Acar Z, Sasani H. Relationship between pruritus and autotaxin in intrahepatic cholestasis of pregnancy. Gastroenterol Hepatol 2020; 44:96-102. [PMID: 33010963 DOI: 10.1016/j.gastrohep.2020.08.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/10/2020] [Accepted: 08/16/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Intrahepatic cholestasis of pregnancy is a temporary, pregnancy-specific disease that resolves with delivery, characterized by itching (pruritus), as well as high transaminase and serum bile acid levels in the third trimester of pregnancy. Due to the effects of Autotaxin on the physiology of pregnancy, we aimed to investigate Autotaxin activity in patients with intrahepatic cholestasis of pregnancy. PATIENTS AND METHODS Sixty-nine patients diagnosed with intrahepatic cholestasis of pregnancy and 20 healthy pregnant women were enrolled in the study. Fasting serum bile acid, pruritus intensity, serum parameters, gestational week of the patients at the time of diagnosis were recorded, and birth week and birth weight were monitored. Autotaxin serum level was measured enzymatically. RESULTS The mean serum bile acid level (n=69; 38.74±35.92μmol/L) in patients with intrahepatic cholestasis of pregnancy (n=69) was detected to be higher than healthy pregnant women (n=20; 5.05±1.88μmol/L) (p<0.001). Weak correlation was detected between serum bile acid level and itch intensity (p=0.014, r=0.295), while no relation was detected between Autotaxin and itch intensity (p=0.446, r=0.09). Although mean Autotaxin (intrahepatic cholestasis of pregnancy: 678.10±424.42pg/mL, control: 535.16±256.47pg/mL) levels were high in patients with intrahepatic cholestasis of pregnancy, it was not statistically significant (p=0.157). CONCLUSION In our study, we observed that the serum Autotaxin level did not make a significant difference in patients with intrahepatic cholestasis of pregnancy compared to healthy pregnant women. These findings suggest that larger clinical studies are required to reveal the physio-pathological effects of Autotaxin on pregnancy.
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Affiliation(s)
- Sami Cifci
- Basaksehir Cam and Sakura City Hospital, Department of Gastroenterology, Istanbul, Turkey
| | - Kader Irak
- SBU Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey
| | - Mehmet Bayram
- SBU Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey
| | - Nergiz Ekmen
- Gazi University Medical Faculty, Department of Gastroenterology, Ankara, Turkey.
| | - Cemal Kazezoglu
- SBU Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Department of Biochemistry, Istanbul, Turkey
| | - Zuat Acar
- SBU Sarıyer Hamidiye Etfal Training and Research Hospital, Department of Perinatology, Istanbul, Turkey
| | - Hadi Sasani
- Tekirdag Namık Kemal University, Faculty of Medicine, Department of Radiology, Tekirdag, Turkey
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Bolacali M, Irak K. Effect of dietary yeast autolysate on performance, slaughter, and carcass characteristics, as well as blood parameters, in quail of both genders. S AFR J ANIM SCI 2017. [DOI: 10.4314/sajas.v47i4.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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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Eminler AT, Uslan MI, Ayyildiz T, Irak K, Kiyici M, Gurel S, Dolar E, Gulten M, Nak SG. Mean platelet volume is an important predictor of hepatitis C but not hepatitis B liver damage. J Res Med Sci 2016; 20:865-70. [PMID: 26759574 PMCID: PMC4696372 DOI: 10.4103/1735-1995.170609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The mean platelet volume (MPV) is the most commonly used measure of platelet size and is a potential marker of platelet reactivity. In this study, we aimed to explore the relationship between hepatic histopathology in viral hepatitis and MPV levels, which are associated with platelet count and activity. MATERIALS AND METHODS We performed a retrospective case-control study of baseline histological and clinical parameters in chronic hepatitis B and C patients in our tertiary reference center between January 2005 and January 2011. Two hundred and five chronic hepatitis B patients and 133 chronic hepatitis C patients who underwent liver biopsy were included in the study. The patients were divided into two groups: Chronic hepatitis B and chronic hepatitis C and were additionally divided into groups of two according to histological activity index (HAI) and fibrosis scores obtained by liver biopsy results (according to the Ishak scoring system). The clinical characteristics of chronic viral hepatitis patients, including demographics, laboratory (especially MPV), and liver biopsy findings, were reviewed. RESULTS One hundred and forty-three patients were male (69.1%), and the mean age was 41.9 ± 12.75 with an age range of 18-71 years in hepatitis B patients. In the classification made according to HAI, 181 patients were in the low activity group (88.3%) and 24 in the high activity group (11.7%). In the evaluation made according to fibrosis score, 169 patients were found to have early fibrosis (82.4%) and 36 were found to have advanced fibrosis (17.6%). In patients with hepatitis B, there was no statistically significant difference in terms of their MPV values between the two groups, separated according to their degree of activity and fibrosis. Sixty-three patients were male (47.3%), and the mean age was 50.03 ± 12.75 with an age range of 19-75 years. In the classification made according to HAI, 109 patients were in low activity group (81.9%) and 24 in high activity group (18.1%). In the evaluation made according to fibrosis score, 101 patients were found to have early fibrosis (75.9%) and 32 have advanced fibrosis (24.1%). There was a statistically significant difference between the activity and fibrosis groups of the hepatitis C patients (P = 0.04 and P = 0.02, respectively). CONCLUSION MPV values are more reliable in hepatitis C patients than hepatitis B for predicting the advanced damage in liver histology. This finding might be useful for the detection of early fibrosis and also starting early treatment, which is important in hepatitis C.
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Affiliation(s)
- Ahmet Tarik Eminler
- Department of Gastroenterology, Sakarya University, Adapazarı, Sakarya, Turkey
| | - Mustafa Ihsan Uslan
- Department of Gastroenterology, Sakarya University, Adapazarı, Sakarya, Turkey
| | - Talat Ayyildiz
- Department of Gastroenterology, Ondokuz Mayis University, Samsun, Turkey
| | - Kader Irak
- Department of Gastroenterology, Uludag University, Bursa, Turkey
| | - Murat Kiyici
- Department of Gastroenterology, Uludag University, Bursa, Turkey
| | - Selim Gurel
- Department of Gastroenterology, Uludag University, Bursa, Turkey
| | - Enver Dolar
- Department of Gastroenterology, Uludag University, Bursa, Turkey
| | - Macit Gulten
- Department of Gastroenterology, Uludag University, Bursa, Turkey
| | - Selim Giray Nak
- Department of Gastroenterology, Uludag University, Bursa, Turkey
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Eminler AT, Irak K, Ayyildiz T, Keskin M, Kiyici M, Gurel S, Gulten M, Dolar E, Nak SG. The relation between liver histopathology and GGT levels in viral hepatitis: more important in hepatitis B. Turk J Gastroenterol 2015; 25:411-5. [PMID: 25254524 DOI: 10.5152/tjg.2014.3693] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS To investigate the relationship between gamma-glutamyl transpeptidase (GGT) levels and histopathological status determined by biopsy in patients with chronic hepatitis B and C. MATERIALS AND METHODS Patients with chronic hepatitis B and C who were referred to the Uludağ University Faculty of Medicine Gastroenterology outpatient clinic between January 2005-January 2011 and underwent liver biopsy were included in the study. Overall, 246 patients with hepatitis B and 151 patients with hepatitis C were enrolled. According to the evaluation based on the Ishak score, patients with a histological activity index (HAI) between 0-12 were defined as low activity, and those with an HAI between 13-18 were defined as high activity. In addition, patients with a fibrosis score of 0-2 were defined as low fibrosis, and those with a score between 3-6 were defined as high fibrosis; comparisons were made accordingly. RESULTS In patients with hepatitis B, the mean GGT level was 38.86±42.4 (IU/L) in the low activity group and 60.44±44.4 (IU/L) in the high activity group (p<0.05). In hepatitis B patients, the mean GGT level was 26.89±14.83 (IU/L) in the low fibrosis group, whereas it was 65.60±59.7 (IU/L) in the high fibrosis group (p<0.001). There was no significant difference between HAI and fibrosis group with regard to GGT levels in the hepatitis C patients. CONCLUSION In conclusion, it is proposed that in patients with chronic viral hepatitis, GGT levels can be taken into consideration to predict advanced histological liver damage, especially in patients with hepatitis B.
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Affiliation(s)
- Ahmet Tarik Eminler
- Department of Gastroenterology, Uludağ University Faculty of Medicine, Bursa, Turkey.
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Emınler AT, Ayyildiz T, Irak K, Dolar E. Tuberculous peritonitis case at advanced age presenting with chylous ascites. Turk J Gastroenterol 2013; 23:423-5. [PMID: 22965525 DOI: 10.4318/tjg.2012.0382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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