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Jang TY, Ho CC, Wu CD, Dai CY, Chen PC. Air pollution as a potential risk factor for hepatocellular carcinoma in Taiwanese patients after adjusting for chronic viral hepatitis. J Chin Med Assoc 2024; 87:287-291. [PMID: 38206793 DOI: 10.1097/jcma.0000000000001053] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Air pollution is a risk factor for hepatocellular carcinoma (HCC). However, the effect of air pollution on HCC risk in patients with hepatitis remains unclear. METHODS This cross-sectional study recruited 348 patients with chronic hepatitis who were tested for serum hepatitis B surface antigen (HBsAg) and for antibodies against hepatitis B core antigen (HBcIgG) and hepatitis C virus (anti-HCV) in 2022. The diagnosis of HCC was based on the International Classification of Diseases, 10th revision (ICD-10). Daily estimates of air pollutants were aggregated into mean estimates for the previous year based on the date of recruitment or HCC diagnosis. RESULTS Out of 348 patients, 12 had HCC (3.4%). Patients with HCC were older (71.7 vs 50.9 years; p = 0.004), had higher proportion of HBsAg seropositivity (41.7% vs 5.1%; p < 0.001), and substantially higher levels of particulate matter 2.5 (PM 2.5 ) (21.5 vs 18.2 μg/m 3 ; p = 0.05). Logistic regression analysis revealed that the factors associated with HCC were age (odds ratio [OR]: 1.10; CI, 1.03-1.17; p = 0.01), PM 2.5 level (OR: 1.51; CI, 1.02-2.23; p = 0.04), and HBsAg seropositivity (OR: 6.60; CI, 1.51-28.85; p = 0.01) ( Table 3 ). There was a combined effect of PM 2.5 and HBsAg seropositivity on the risk of HCC development (OR: 22.17; CI, 3.33-147.45; p = 0.001). CONCLUSION In this study, we demonstrated that PM 2.5 and HBsAg seropositivity were associated with HCC occurrence and had synergistic effects after adjusting for confounding factors.
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Affiliation(s)
- Tyng-Yuan Jang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan, ROC
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan, ROC
| | - Chi-Chang Ho
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan, ROC
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan, ROC
- Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Tainan, Taiwan, ROC
| | - Chia-Yen Dai
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan, ROC
- Department of Public Health, National Taiwan University, Taipei, Taiwan, ROC
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
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Kamal H, Lindahl K, Ingre M, Gahrton C, Karkkonen K, Nowak P, Vesterbacka J, Stål P, Wedemeyer H, Duberg AS, Aleman S. The cascade of care for patients with chronic hepatitis delta in Southern Stockholm, Sweden for the past 30 years. Liver Int 2024; 44:228-240. [PMID: 37904316 DOI: 10.1111/liv.15770] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND AND AIMS Previous studies have shown suboptimal screening for hepatitis D virus (HDV) among patients with chronic hepatitis B (CHB). This study presents the cascade of care for HDV infection in a major secondary referral centre in Southern Stockholm, Sweden. METHODS HBsAg+ve patients attending Karolinska University Hospital (KUH) from 1992 to 2022 were identified. The prevalence of anti-HDV and/or HDV RNA positivity, interferon (IFN) therapy and maintained virological responses (MVR) after HDV treatment were assessed. Also, time to anti-HDV testing was analysed in relation to liver-related outcomes with logistic regression. RESULTS Among 4095 HBsAg+ve persons, 3703 (90.4%) underwent an anti-HDV screening; within a median of 1.8 months (range 0.0-57.1) after CHB diagnosis. This screening rate increased over time, to 97.9% in the last decade. Overall, 310 (8.4%) were anti-HDV+ve, of which 202 (65.2%) were HDV RNA+ve. Eighty-five (42%) received IFN, and 9 (10.6%) achieved MVR at the last follow-up. The predictive factors for anti-HDV screening were Asian origin, diagnosis after the year 2012, HIV co-infection (negative factor) and HBV DNA level < 2000 IU/mL in univariable analysis, while HIV co-infection was the only remaining factor in multivariable analysis. Delayed anti-HDV test >5 years was independently associated with worsened liver-related outcomes (adjusted odds ratio = 7.6, 95% CI 1.8-31.6). CONCLUSION Higher frequency of HDV screening than previously published data could be seen among CHB patients at KUH in a low-endemic setting. Receiving a delayed screening test seems to be associated with worse outcomes, stressing the need of a strategy for timely HDV diagnosis.
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Affiliation(s)
- Habiba Kamal
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Karin Lindahl
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Michael Ingre
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
- Centre for Bioinformatics and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Caroline Gahrton
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Kerstin Karkkonen
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Piotr Nowak
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Jan Vesterbacka
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Per Stål
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
- Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Heiner Wedemeyer
- Department of Gastroenterology and Hepatology, University of Hannover, Hannover, Germany
| | - Ann-Sofi Duberg
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Soo Aleman
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
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Abstract
Based on the worldwide distribution of hepatitis E virus (HEV) and its ability to cause major epidemics in low-income countries, the global availability of a HEV vaccine is a pressing clinical need. Populations at risk of severe forms of the infection are well characterised: patients with chronic liver disease - at risk of liver failure; pregnant women - at risk of fulminant hepatitis or obstetrical complications; and immunosuppressed patients, particularly those with solid organ transplants - at risk of chronic hepatitis and rapid progression to cirrhosis. Only one hepatitis E vaccine is presently being manufactured. It has been proven to be effective and safe. However, its accessibility, as well as data on its long-term efficacy and the duration of protection it confers, are limited. While individuals considered to be at risk of severe infection appear to be ideal targets for the vaccine, its effectiveness and tolerability have not yet been studied in populations with chronic liver disease and immunosuppressed patients. Hepatitis E vaccination could also play an important role in controlling outbreaks in large waterborne epidemics. Clinical trials on these populations are needed.
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Affiliation(s)
- Jean-Marie Peron
- Service d'Hépatologie, Hôpital Rangueil, CHU de Toulouse, Université Paul Sabatier Toulouse-III, France
| | - Hélène Larrue
- Service d'Hépatologie, Hôpital Rangueil, CHU de Toulouse, Université Paul Sabatier Toulouse-III, France
| | - Jacques Izopet
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de L'hépatite E, Toulouse, France
| | - Maria Buti
- Liver Unit, Hospital Universitario Valle Hebrón, CIBER del Instituto Carlos III, Barcelona, Spain.
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4
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Dröes FC, Suchodolski JS, Steiner JM, Lidbury JA. Prevalence of portal vein and splanchnic venous thrombosis in dogs with chronic hepatitis. J Small Anim Pract 2023; 64:375-383. [PMID: 36973881 DOI: 10.1111/jsap.13597] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 11/24/2022] [Accepted: 01/24/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES Alterations in haemostasis have been described in dogs and humans with chronic hepatitis. Portal vein thrombosis is a recognised complication of chronic hepatitis in humans; however, its prevalence in dogs with chronic hepatitis has not been reported. We aimed to estimate the prevalence of, and describe clinical and laboratory data of dogs with chronic hepatitis and portal vein thrombosis and splanchnic venous thrombosis. MATERIALS AND METHODS Retrospective cross-sectional study. Medical records of dogs admitted to a veterinary teaching hospital between 2009 and 2019 were reviewed. Dogs were included if chronic hepatitis was histopathologically confirmed, and if diagnostic imaging or necropsy indicated the presence of thrombosis. Clinical and laboratory data (i.e. haematology, biochemistry, coagulation panels) were recorded. Descriptive statistics were used to characterise dogs with and without thrombosis. RESULTS Records from 136 dogs with chronic hepatitis were identified. Three of these dogs, 2.2% (95% confidence interval: 0.8 to 6.3%) all females, were diagnosed with portal vein thrombosis. Five dogs in total, (3.7%; 95% confidence interval: 1.6 to 8.3%), including three with portal vein thrombosis, all females, were diagnosed with splanchnic venous thrombosis. Dogs with portal vein and splanchnic venous thrombosis often had hyperbilirubinaemia, increased serum gamma-glutamyl transferase activity, and decreased plasma antithrombin 3 activity. They also had relatively high alternative Child-Pugh scores for dogs (median 6 out of 13). CLINICAL SIGNIFICANCE Portal vein and splanchnic venous thrombosis are potentially serious complications that were identified in a relatively low proportion of dogs with chronic hepatitis.
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Affiliation(s)
- F C Dröes
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| | - J A Lidbury
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
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Boulahtouf Z, Virzì A, Baumert TF, Verrier ER, Lupberger J. Signaling Induced by Chronic Viral Hepatitis: Dependence and Consequences. Int J Mol Sci 2022; 23:ijms23052787. [PMID: 35269929 PMCID: PMC8911453 DOI: 10.3390/ijms23052787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 12/12/2022] Open
Abstract
Chronic viral hepatitis is a main cause of liver disease and hepatocellular carcinoma. There are striking similarities in the pathological impact of hepatitis B, C, and D, although these diseases are caused by very different viruses. Paired with the conventional study of protein-host interactions, the rapid technological development of -omics and bioinformatics has allowed highlighting the important role of signaling networks in viral pathogenesis. In this review, we provide an integrated look on the three major viruses associated with chronic viral hepatitis in patients, summarizing similarities and differences in virus-induced cellular signaling relevant to the viral life cycles and liver disease progression.
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Affiliation(s)
- Zakaria Boulahtouf
- Institut de Recherche sur les Maladies Virales et Hepatiques UMR_S1110, Université de Strasbourg, Inserm, F-67000 Strasbourg, France; (Z.B.); (A.V.); (T.F.B.); (E.R.V.)
| | - Alessia Virzì
- Institut de Recherche sur les Maladies Virales et Hepatiques UMR_S1110, Université de Strasbourg, Inserm, F-67000 Strasbourg, France; (Z.B.); (A.V.); (T.F.B.); (E.R.V.)
| | - Thomas F. Baumert
- Institut de Recherche sur les Maladies Virales et Hepatiques UMR_S1110, Université de Strasbourg, Inserm, F-67000 Strasbourg, France; (Z.B.); (A.V.); (T.F.B.); (E.R.V.)
- Service d’Hépato-Gastroentérologie, Hôpitaux Universitaires de Strasbourg, F-67000 Strasbourg, France
- Institut Universitaire de France (IUF), F-75005 Paris, France
| | - Eloi R. Verrier
- Institut de Recherche sur les Maladies Virales et Hepatiques UMR_S1110, Université de Strasbourg, Inserm, F-67000 Strasbourg, France; (Z.B.); (A.V.); (T.F.B.); (E.R.V.)
| | - Joachim Lupberger
- Institut de Recherche sur les Maladies Virales et Hepatiques UMR_S1110, Université de Strasbourg, Inserm, F-67000 Strasbourg, France; (Z.B.); (A.V.); (T.F.B.); (E.R.V.)
- Correspondence:
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Hassona MM, Radwan EM, Abdelsameea E, Estaphan S, Abd Elrhman HE, Abdel-Samiee M, Naguib M. The Putative Role of Natural Killer Cells in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma. Asian Pac J Cancer Prev 2021; 22:2559-2567. [PMID: 34452571 PMCID: PMC8629465 DOI: 10.31557/apjcp.2021.22.8.2559] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/12/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Natural Killer (NK) cells have crucial roles in immune responses against malignant transformation including hepatocellular carcinoma (HCC). The NKG2D receptor has a critical role in the NK recognition of target cells. AIM We assessed NKG2D receptor expression as a diagnostic biomarker for HCC detection and progression in Egyptian patients with hepatitis C virus (HCV)-related HCC. METHODS We classified 81 patients into three groups: chronic hepatitis (21), cirrhotic (30) and HCC (30) patients, with 36 individuals enrolled to the control group. We analyzed NK levels in peripheral blood and NKG2D receptor expression in NK cells using flow cytometry. RESULTS We observed a significant decrease in NKG2D (CD314) expression on circulating NK cells and frequency of NK cells expressing NKG2D (CD314) in HCC patients. Also, in patients, larger foci lesions significantly correlated with decreased NK cell numbers. Multiple foci numbers and patients with a Child score C significantly correlated with decreased circulating NK cells expressing NKG2D and decreased NKG2D expression. CONCLUSION The percentage of NK cells in peripheral blood and NKG2D receptor expression could function as potential biomarkers for HCC detection and progression.
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Affiliation(s)
- Mona M Hassona
- Department of Clinical and Chemical Pathology, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
| | - Enas M Radwan
- Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - Eman Abdelsameea
- Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
| | - Suzanne Estaphan
- Department of Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Heba E Abd Elrhman
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
| | - Mohamed Abdel-Samiee
- Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
| | - Mary Naguib
- Department of Clinical and Chemical Pathology, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
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7
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Vuille-Lessard É, Montani M, Bosch J, Semmo N. Autoimmune hepatitis triggered by SARS-CoV-2 vaccination. J Autoimmun 2021; 123:102710. [PMID: 34332438 PMCID: PMC8316013 DOI: 10.1016/j.jaut.2021.102710] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/15/2021] [Accepted: 07/24/2021] [Indexed: 12/26/2022]
Abstract
The development of autoimmune diseases has been reported after SARS-CoV-2 infection. Vaccination against SARS-CoV-2 could also trigger auto-immunity, as it has been described with other vaccines. An aberrant immune response induced by molecular mimicry and bystander activation, especially in predisposed individuals, is a potential mechanism. We report the case of a 76-year-old woman with Hashimoto thyroiditis and prior COVID-19 infection who developed severe autoimmune hepatitis (with typical features including strongly positive anti-smooth muscle antibody and markedly elevated immunoglobulins G, as well as typical histological findings) following SARS-CoV-2 vaccination (mRNA-1273 SARS-CoV-2 vaccine, Moderna®). The link between SARS-CoV-2 vaccination and the development of autoimmune diseases needs to be further investigated. Although a causality relationship cannot be proven, caution may be warranted when vaccinating individuals with known autoimmune diseases.
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Affiliation(s)
- Élise Vuille-Lessard
- Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Department of Biomedical Research, University of Bern, Bern, Switzerland.
| | - Matteo Montani
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Jaume Bosch
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Nasser Semmo
- Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Department of Biomedical Research, University of Bern, Bern, Switzerland.
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Mohr R, Özdirik B, Lambrecht J, Demir M, Eschrich J, Geisler L, Hellberg T, Loosen SH, Luedde T, Tacke F, Hammerich L, Roderburg C. From Liver Cirrhosis to Cancer: The Role of Micro-RNAs in Hepatocarcinogenesis. Int J Mol Sci 2021; 22:1492. [PMID: 33540837 PMCID: PMC7867354 DOI: 10.3390/ijms22031492] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/23/2021] [Accepted: 01/28/2021] [Indexed: 12/19/2022] Open
Abstract
In almost all cases, hepatocellular carcinoma (HCC) develops as the endpoint of a sequence that starts with chronic liver injury, progresses to liver cirrhosis, and finally, over years and decades, results in liver cancer. Recently, the role of non-coding RNA such as microRNA (miRNA) has been demonstrated in the context of chronic liver diseases and HCC. Moreover, data from a phase II trial suggested a potential role of microRNAs as therapeutics in hepatitis-C-virus infection, representing a significant risk factor for development of liver cirrhosis and HCC. Despite progress in the clinical management of chronic liver diseases, pharmacological treatment options for patients with liver cirrhosis and/or advanced HCC are still limited. With their potential to regulate whole networks of genes, miRNA might be used as novel therapeutics in these patients but could also serve as biomarkers for improved patient stratification. In this review, we discuss available data on the role of miRNA in the transition from liver cirrhosis to HCC. We highlight opportunities for clinical translation and discuss open issues applicable to future developments.
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Affiliation(s)
- Raphael Mohr
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Burcin Özdirik
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Joeri Lambrecht
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Münevver Demir
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Johannes Eschrich
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Lukas Geisler
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Teresa Hellberg
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Sven H. Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany; (S.H.L.); (T.L.)
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany; (S.H.L.); (T.L.)
| | - Frank Tacke
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Linda Hammerich
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
| | - Christoph Roderburg
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (B.Ö.); (J.L.); (M.D.); (J.E.); (L.G.); (T.H.); (F.T.); (L.H.); (C.R.)
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany; (S.H.L.); (T.L.)
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Fan R, Papatheodoridis G, Sun J, Innes H, Toyoda H, Xie Q, Mo S, Sypsa V, Guha IN, Kumada T, Niu J, Dalekos G, Yasuda S, Barnes E, Lian J, Suri V, Idilman R, Barclay ST, Dou X, Berg T, Hayes PC, Flaherty JF, Zhou Y, Zhang Z, Buti M, Hutchinson SJ, Guo Y, Calleja JL, Lin L, Zhao L, Chen Y, Janssen HLA, Zhu C, Shi L, Tang X, Gaggar A, Wei L, Jia J, Irving WL, Johnson PJ, Lampertico P, Hou J. aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis. J Hepatol 2020; 73:1368-1378. [PMID: 32707225 DOI: 10.1016/j.jhep.2020.07.025] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [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: 05/06/2020] [Revised: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) is the leading cause of death in patients with chronic hepatitis. In this international collaboration, we sought to develop a global universal HCC risk score to predict the HCC development for patients with chronic hepatitis. METHODS A total of 17,374 patients, comprising 10,578 treated Asian patients with chronic hepatitis B (CHB), 2,510 treated Caucasian patients with CHB, 3,566 treated patients with hepatitis C virus (including 2,489 patients with cirrhosis achieving a sustained virological response) and 720 patients with non-viral hepatitis (NVH) from 11 international prospective observational cohorts or randomised controlled trials, were divided into a training cohort (3,688 Asian patients with CHB) and 9 validation cohorts with different aetiologies and ethnicities (n = 13,686). RESULTS We developed an HCC risk score, called the aMAP score (ranging from 0 to 100), that involves only age, male, albumin-bilirubin and platelets. This metric performed excellently in assessing HCC risk not only in patients with hepatitis of different aetiologies, but also in those with different ethnicities (C-index: 0.82-0.87). Cut-off values of 50 and 60 were best for discriminating HCC risk. The 3- or 5-year cumulative incidences of HCC were 0-0.8%, 1.5-4.8%, and 8.1-19.9% in the low- (n = 7,413, 43.6%), medium- (n = 6,529, 38.4%), and high-risk (n = 3,044, 17.9%) groups, respectively. The cut-off value of 50 was associated with a sensitivity of 85.7-100% and a negative predictive value of 99.3-100%. The cut-off value of 60 resulted in a specificity of 56.6-95.8% and a positive predictive value of 6.6-15.7%. CONCLUSIONS This objective, simple, reliable risk score based on 5 common parameters accurately predicted HCC development, regardless of aetiology and ethnicity, which could help to establish a risk score-guided HCC surveillance strategy worldwide. LAY SUMMARY In this international collaboration, we developed and externally validated a simple, objective and accurate prognostic tool (called the aMAP score), that involves only age, male, albumin-bilirubin and platelets. The aMAP score (ranged from 0 to 100) satisfactorily predicted the risk of hepatocellular carcinoma (HCC) development among over 17,000 patients with viral and non-viral hepatitis from 11 global prospective studies. Our findings show that the aMAP score had excellent discrimination and calibration in assessing the 5-year HCC risk among all the cohorts irrespective of aetiology and ethnicity.
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Affiliation(s)
- Rong Fan
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - George Papatheodoridis
- Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Jian Sun
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hamish Innes
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK
| | - Hidenori Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Qing Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Vana Sypsa
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School of National and Kapodistrian University of Athens, Athens, Greece
| | - Indra Neil Guha
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Takashi Kumada
- Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - Junqi Niu
- Department of Hepatology, First Hospital, Jilin University, Changchun, China
| | - George Dalekos
- Department of Internal Medicine, Thessalia University Medical School, Larissa, Greece
| | - Satoshi Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine and the Oxford NIHR Biomedical Research Centre, Oxford University, Oxford, UK
| | - Jianqi Lian
- Centers of Infectious Diseases, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | | | - Ramazan Idilman
- Department of Gastroenterology, University of Ankara Medical School, Ankara, Turkey
| | | | - Xiaoguang Dou
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, China
| | - Thomas Berg
- Division of Hepatology, Clinic and Polyclinic for Gastroenterology, Hepatology Infectious Disease and Pneumology, University Clinic Leipzig, Leipzig, Germany
| | | | | | - Yuanping Zhou
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhengang Zhang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Maria Buti
- Hospital General Universitario Valle Hebron and Ciberehd, Barcelona, Spain
| | - Sharon J Hutchinson
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK
| | - Yabing Guo
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | | | - Longfeng Zhao
- Department of Infectious Diseases, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yongpeng Chen
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Harry L A Janssen
- Liver Clinic, Toronto Western & General Hospital, University Health Network, Toronto, ON, Canada
| | - Chaonan Zhu
- Big Data Research and Biostatistics Center, Hangzhou YITU Healthcare Technology Co. Ltd., Hangzhou, China
| | - Lei Shi
- Big Data Research and Biostatistics Center, Hangzhou YITU Healthcare Technology Co. Ltd., Hangzhou, China
| | - Xiaoping Tang
- Guangzhou Eighth People's Hospital, Guangzhou, China
| | | | - Lai Wei
- Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - William L Irving
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Philip J Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
| | - Pietro Lampertico
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico - Division of Gastroenterology and Hepatology - CRC 'A.M. and A. Migliavacca' Center for Liver Disease, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Jinlin Hou
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Abstract
Nowadays, shear wave elastographic techniques have brought a substantial reduction of liver biopsies performed to stage liver fibrosis in patients with chronic hepatitis. The availability of accurate noninvasive methods for the assessment of liver fibrosis was an important breakthrough and prompted ultrasound federations of societies as well as clinical and radiologic societies to issue international guidelines or consensus statements on the clinical applications of shear wave elastographic techniques. This article reviews the guidelines that have been published as of today.
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Affiliation(s)
- Giovanna Ferraioli
- Clinical Sciences and Infectious Diseases Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Medical School, University of Pavia, Pavia, Italy
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11
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Abstract
RATIONALE Acute hepatitis E virus (HEV) infections are usually self-limiting in immunocompetent patients. HEV persistence has been described only in immunosuppressed patients such as solid-organ transplant recipients, patients with hematological diseases, or patients with human immunodeficiency virus (HIV) infection. PATIENT CONCERNS A 61-year-old patient was admitted in hospital for jaundice and asthenia. DIAGNOSES The patient had underlying cirrhosis and developed a chronic HEV infection. INTERVENTION Ribavirin therapy was initiated. OUTCOMES Ribavirin therapy for 12 months allowed the clearance of the virus and HEV viral load remained undetectable thereafter. This patient had taken no immunosuppressive drugs, was not suffering from any autoimmune disease and was not infected with HIV. We studied the patient's anti-HEV immune response months after the viral clearance. His peripheral blood mononuclear cells (PBMC) were stimulated in vitro by HEV peptides. The patient had a mild T lymphopenia, but polyclonal stimulation of PBMC showed a robust T cell response. The response of his anti-HEV specific interferon-γ producing T cells was low. LESSONS Other studies are now needed to identify the population with a chronic evolution of HEV infection despite no apparent immunodepression.
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Affiliation(s)
- Hugo Barragué
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, Toulouse
| | | | | | - Eric Champagne
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, Toulouse
| | | | - Jacques Izopet
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, Toulouse
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut fédératif de biologie de Purpan, Toulouse, France
| | - Florence Abravanel
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, Toulouse
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut fédératif de biologie de Purpan, Toulouse, France
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Amougou Atsama M, Atangana PJA, Noah Noah D, Moundipa PF, Pineau P, Njouom R. Hepatitis E virus infection as a promoting factor for hepatocellular carcinoma in Cameroon: Preliminary Observations. Int J Infect Dis 2017; 64:4-8. [PMID: 28847760 DOI: 10.1016/j.ijid.2017.08.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 05/19/2017] [Revised: 07/25/2017] [Accepted: 08/17/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine the seroprevalence of hepatitis E virus (HEV) infection in patients with chronic hepatitis and/or hepatocellular carcinoma (HCC) and to assess its potential consequences for disease progression. METHODS We conducted a prospective case-control study on patients with HCC hepatitis B or C related and non-HCC patients including patients with CLD and patients without clinical evidence of liver disease. Anti-HEV IgG and IgM were tested by ELISA using commercially available kits. Liver damage was assessed by alanine aminotransferase, aspartate aminotransferase, platelets and prothrombin measurements. RESULTS We observed a significant anti-HEV IgG carriage in HCC patients compared to non-HCC subjects with CLD (41.8% vs 12.6%; P=9.1 E-6; OR=4.8, 95%CI: 2.3-10.6). HCC patients with HEV infection display more profound alterations of circulating liver enzymes, platelets count and prothrombin time than HCC patients without sero-reactivity to HEV. CONCLUSION Overall, this study indicates a high prevalence of HEV infection in Cameroonian patients with CLD and HCC. These data suggest either that patients with liver tumors are more susceptible to hepeviral infection or that, in a tropical context, HEV might promote the progression of liver diseases towards tumor.
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Affiliation(s)
- Marie Amougou Atsama
- Centre Pasteur of Cameroon, Yaounde, Cameroon; Laboratory of Pharmacology and Toxicology of University of Yaounde I, Yaounde, Cameroon.
| | | | | | - Paul Fewou Moundipa
- Laboratory of Pharmacology and Toxicology of University of Yaounde I, Yaounde, Cameroon.
| | - Pascal Pineau
- Unité « Organisation nucléaire et Oncogenèse », INSERM U993, Institut Pasteur, Paris, France.
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13
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Mohs A, Kuttkat N, Reißing J, Zimmermann HW, Sonntag R, Proudfoot A, Youssef SA, de Bruin A, Cubero FJ, Trautwein C. Functional role of CCL5/RANTES for HCC progression during chronic liver disease. J Hepatol 2017; 66:743-753. [PMID: 28011329 DOI: 10.1016/j.jhep.2016.12.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [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] [Received: 02/10/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND & AIMS During liver inflammation, triggering fibrogenesis and carcinogenesis immune cells play a pivotal role. In the present study we investigated the role of CCL5 in human and in murine models of chronic liver inflammation leading to hepatocellular carcinoma (HCC) development. METHODS CCL5 expression and its receptors were studied in well-defined patients with chronic liver disease (CLD) and in two murine inflammation based HCC models. The role of CCL5 in inflammation, fibrosis, tumor initiation and progression was analyzed in different cell populations of NEMOΔhepa/CCL5-/- animals and after bone marrow transplantation (BMT). For therapeutic intervention Evasin-4 was injected for 24h or 8weeks. RESULTS In CLD patients, CCL5 and its receptor CCR5 are overexpressed - an observation confirmed in the Mdr2-/- and NEMOΔhepa model. CCL5 deletion in NEMOΔhepa mice diminished hepatocyte apoptosis, compensatory proliferation and fibrogenesis due to reduced immune cell infiltration. Especially, CD45+/Ly6G+ granulocytes, CD45+/CD11b+/Gr1.1+/F4/80+ pro-inflammatory monocytes, CD4+ and CD8+ T cells were decreased. One year old NEMOΔhepa/CCL5-/- mice displayed smaller and less malignant tumors, characterized by reduced proliferative capacity and less pronounced angiogenesis. We identified hematopoietic cells as the main source of CCL5, while CCL5 deficiency did not sensitise NEMOΔhepa hepatocytes towards TNFα induced apoptosis. Finally, therapeutic intervention with Evasin-4 over a period of 8weeks ameliorated liver disease progression. CONCLUSION We identified an important role of CCL5 in human and functionally in mice with disease progression, especially HCC development. A novel approach to inhibit CCL5 in vivo thus appears encouraging for patients with CLD. LAY SUMMARY Our present study identifies the essential role of the chemoattractive cytokine CCL5 for liver disease progression and especially hepatocellular carcinoma development in men and mice. Finally, the inhibition of CCL5 appears to be encouraging for therapy of human chronic liver disease.
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MESH Headings
- Animals
- Carcinoma, Hepatocellular/etiology
- Carcinoma, Hepatocellular/genetics
- Carcinoma, Hepatocellular/immunology
- Chemokine CCL5/antagonists & inhibitors
- Chemokine CCL5/deficiency
- Chemokine CCL5/genetics
- Chemokine CCL5/metabolism
- Disease Progression
- Hematopoiesis/immunology
- Hepatitis, Chronic/complications
- Hepatitis, Chronic/genetics
- Hepatitis, Chronic/immunology
- Humans
- Liver Cirrhosis/etiology
- Liver Cirrhosis/immunology
- Liver Cirrhosis/pathology
- Liver Neoplasms/etiology
- Liver Neoplasms/genetics
- Liver Neoplasms/immunology
- Liver Neoplasms, Experimental/etiology
- Liver Neoplasms, Experimental/immunology
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptors, CCR5/metabolism
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Affiliation(s)
- Antje Mohs
- Department of Internal Medicine III, University Hospital, RWTH Aachen, Aachen, Germany
| | - Nadine Kuttkat
- Department of Internal Medicine III, University Hospital, RWTH Aachen, Aachen, Germany
| | - Johanna Reißing
- Department of Internal Medicine III, University Hospital, RWTH Aachen, Aachen, Germany
| | | | - Roland Sonntag
- Department of Internal Medicine III, University Hospital, RWTH Aachen, Aachen, Germany
| | - Amanda Proudfoot
- Merck Serono Geneva Research Centre, Case postale 54, chemin des Mines 9, Geneva CH-1211 20, Switzerland
| | - Sameh A Youssef
- Dutch Molecular Pathology Center, Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3508 TB Utrecht, The Netherlands
| | - Alain de Bruin
- Dutch Molecular Pathology Center, Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3508 TB Utrecht, The Netherlands; University Medical Center Groningen, Department of Pediatrics, University of Groningen, NL-9713 Groningen, The Netherlands
| | | | - Christian Trautwein
- Department of Internal Medicine III, University Hospital, RWTH Aachen, Aachen, Germany.
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14
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Jeon I, Cho ES, Kim JH, Kim DJ, Yu JS, Chung JJ. Feasibility of 10-Minute Delayed Hepatocyte Phase Imaging Using a 30° Flip Angle in Gd-EOB-DTPA-Enhanced Liver MRI for the Detection of Hepatocellular Carcinoma in Patients with Chronic Hepatitis or Cirrhosis. PLoS One 2016; 11:e0167701. [PMID: 27936106 PMCID: PMC5147964 DOI: 10.1371/journal.pone.0167701] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 11/18/2016] [Indexed: 02/06/2023] Open
Abstract
Objectives To compare 10-minute (min) delayed hepatocyte phase imaging (HPI) using a 30° flip angle (FA) (10m-FA30) and 20-min delayed HPI using a 10° FA (20m-FA10) or 30° FA (20m-FA30) in Gd-EOB-DTPA-enhanced MRI in patients with chronic hepatitis or cirrhosis, in terms of lesion-to-liver contrast-to-noise ratio (CNR) for hepatocellular carcinoma (HCC) and detection sensitivity for focal hepatic lesions (FHLs). Materials and Methods One hundred and four patients with 168 HCCs and 55 benign FHLs who underwent Gd-EOB-DTPA-enhanced MRI with 10m-FA30, 20m-FA10, and 20m-FA30 were enrolled. Patients were divided into two groups according to the Child-Pugh classification: group A with chronic hepatitis or Child-Pugh A cirrhosis and group B with Child-Pugh B or C cirrhosis. Lesion-to-liver CNR for HCCs was compared between 10m-FA30 and 20m-FA10 or 20m-FA30 for each group. The presence of FHLs was evaluated using a four-point scale by two independent reviewers, and the detection sensitivity was analyzed. Results In group A, the CNR for HCCs (n = 86) on 10m-FA30 (165.8 ± 99.7) was significantly higher than that on 20m-FA10 (113.4 ± 71.4) and lower than that of 20m-FA30 (210.2 ± 129.3). However, there was no significant difference in the sensitivity of FHL detection between 10m-FA30 (mean 95.0% for two reviewers) and 20m-FA10 (94.7%) or 20m-FA30 (94.7%). In group B, the CNR (54.0 ± 36.4) for HCCs (n = 57) and the sensitivity (94.2%) of FHL detection for 10m-FA30 were significantly higher than those for 20m-FA10 (41.8 ± 36.4 and 80.8%, respectively) and were not different from those for 20m-FA30 (62.7 ± 44.4 and 93.3%, respectively). Conclusion The diagnostic performance of 10m-FA30 was similar to or higher than 20m-FA10 or 20m-FA30 in both groups A and B. This finding indicates that 10m-FA30 could replace 20-min delayed HPI regardless of patient liver function and reduce the delay time by 10 minutes.
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Affiliation(s)
- Inhwan Jeon
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Eun-Suk Cho
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
- * E-mail:
| | - Joo Hee Kim
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Dae Jung Kim
- Department of Radiology, CHA University, CHA Bundang Medical Center, Seongnam-si, Korea
| | - Jeong-Sik Yu
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Jae-Joon Chung
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
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Stein J, Connor S, Virgin G, Ong DEH, Pereyra L. Anemia and iron deficiency in gastrointestinal and liver conditions. World J Gastroenterol 2016; 22:7908-7925. [PMID: 27672287 PMCID: PMC5028806 DOI: 10.3748/wjg.v22.i35.7908] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/18/2016] [Accepted: 08/10/2016] [Indexed: 02/06/2023] Open
Abstract
Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice.
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Abstract
OBJECTIVE The burden of cancer among persons living with HIV/AIDS (PLWHA) is substantial and increasing. We assessed the prevalence of modifiable cancer risk factors among adult PLWHA in Western high-income countries since 2000. DESIGN Meta-analysis. METHODS We searched PubMed to identify articles published in 2011-2013 reporting prevalence of smoking, alcohol consumption, overweight/obesity, and infection with human papillomavirus (HPV), hepatitis C virus (HCV) and hepatitis B virus (HBV) among PLWHA. We conducted random effects meta-analyses of prevalence for each risk factor, including estimation of overall, sex-specific, and HIV-transmission-group-specific prevalence. We compared prevalence in PLWHA with published prevalence estimates in US adults. RESULTS The meta-analysis included 113 publications. Overall summary prevalence estimates were current smoking, 54% [95% confidence interval (CI) 49-59%] versus 20-23% in US adults; cervical high-risk HPV infection, 46% (95% CI 34-58%) versus 29% in US females; oral high-risk HPV infection, 16% (95% CI 10-23%) versus 4% in US adults; anal high-risk HPV infection (men who have sex with men), 68% (95% CI 57-79%), with no comparison estimate available; chronic HCV infection, 26% (95% CI 21-30%) versus 0.9% in US adults; and HBV infection, 5% (95% CI 4-5%) versus 0.3% in US adults. Overweight/obesity prevalence (53%; 95% CI 46-59%) was below that of US adults (68%). Meta-analysis of alcohol consumption prevalence was impeded by varying assessment methods. Overall, we observed considerable study heterogeneity in prevalence estimates. CONCLUSION Prevalence of smoking and oncogenic virus infections continues to be extraordinarily high among PLWHA, indicating a vital need for risk factor reduction efforts.
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Affiliation(s)
- Lesley S Park
- aDivision of Endocrinology, Gerontology, and Metabolism, Department of Medicine and Division of Epidemiology, Department of Health Policy and Research, Stanford University School of Medicine, Stanford, CaliforniabDepartment of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, ConnecticutcDivision of Research, Kaiser Permanente, Oakland, CaliforniadDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.*Lesley S. Park and Raúl U. Hernández-Ramírez contributed equally to this article
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Takashima T, Iijma H, Nishiguchi S. [Diagnosis of liver fibrosis in patients with chronic hepatitis using serum enhanced liver fibrosis (ELF)]. Nihon Rinsho 2015; 73 Suppl 9:145-149. [PMID: 26845920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Kondo Y, Shimosegawa T. [Management of extra-hepatic diseases in chronic viral hepatitis]. Nihon Rinsho 2015; 73 Suppl 9:316-320. [PMID: 26845952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hiraoka A, Aibiki T, Okudaira T, Toshimori A, Kawamura T, Nakahara H, Suga Y, Azemoto N, Miyata H, Miyamoto Y, Ninomiya T, Hirooka M, Abe M, Matsuura B, Hiasa Y, Michitaka K. Muscle atrophy as pre-sarcopenia in Japanese patients with chronic liver disease: computed tomography is useful for evaluation. J Gastroenterol 2015; 50:1206-13. [PMID: 25820219 PMCID: PMC4673094 DOI: 10.1007/s00535-015-1068-x] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/15/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIM The definition of muscle atrophy (pre-sarcopenia) and its diagnostic criteria have not been well reported. To elucidate the frequency of pre-sarcopenia in chronic liver disease (CLD), we examined clinical features of Japanese CLD patients using abdominal computed tomography (CT) findings. METHODS We enrolled 988 CLD (736 with naïve hepatocellular carcinoma) and 372 normal control subjects (NCs). The psoas muscle area index [PI, psoas muscle area at the mid-L3 level in CT (cm(2))/height (m)(2)] was calculated using personal computer software. The cut-off level for pre-sarcopenia was defined as less than two standard deviations (SDs) below the mean PI value in the NCs under 55 years old [males, 45.6 ± 5.7 years (n = 61), 4.24 cm(2)/m(2); females, 47.0 ± 6.1 years (n = 49), 2.50 cm(2)/m(2)]. Elderly was defined as 65 years or older. Clinical features were retrospectively evaluated. RESULTS In the CLD group (HCV:HBV:HBV and HCV:alcohol:non-HBV and HCV = 652:88:7:82:159), pre-sarcopenia was observed in 15.3% of patients with chronic hepatitis (CH), 24.4% of those with liver cirrhosis (LC) Child-Pugh A, 37.7% of those with LC Child-Pugh B, and 37.1% of those with LC Child-Pugh C. A comparison between NC and CH by age (<55, 55-64, 65-74, ≥75 years) showed that the frequency of pre-sarcopenia was higher in CH regardless of age (1.8 vs. 3.6%, 3.2 vs. 15.9%, 4.9 vs. 13.4%, 14.3 vs. 20.2%, respectively). PI values showed correlations with BMI (r = 0.361), age (r = -0.167), albumin (r = 0.115), and branched-chain amino acids (r = 0.199) (P < 0.01). CONCLUSION Retrospective evaluate for pre-sarcopenia was easy to perform with CT findings. Nutrition and exercise instruction should be considered for early stage and even non-elderly CLD as well as LC.
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Affiliation(s)
- Atsushi Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan.
| | - Toshihiko Aibiki
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Tomonari Okudaira
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Akiko Toshimori
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Tomoe Kawamura
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Hiromasa Nakahara
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Yoshifumi Suga
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Nobuaki Azemoto
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Hideki Miyata
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Yasunao Miyamoto
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Tomoyuki Ninomiya
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
| | - Masashi Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Masanori Abe
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Bunzo Matsuura
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Kojiro Michitaka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime, 790-0024, Japan
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Cichoż-Lach H, Tomaszewski M, Kowalik A, Lis E, Tomaszewski A, Lach T, Boczkowska S, Celiński K. QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis. ADV CLIN EXP MED 2015; 24:615-22. [PMID: 26469105 DOI: 10.17219/acem/28681] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Liver cirrhosis is associated with functional abnormalities of the cardiovascular system with co-existing electrocardiographic (ECG) abnormalities. OBJECTIVES The aim was to analyze ECG changes in patients with cirrhosis, to evaluate whether alcoholic etiology of cirrhosis and ascites has an impact on ECG changes. MATERIAL AND METHODS The study involved 81 patients with previously untreated alcoholic cirrhosis (64 patients with ascites, classes B and C according to the Child-Pugh classification; and 17 without ascites, categorized as class A); 41 patients with previously untreated cirrhosis due to chronic hepatitis C (HCV--30 patients with ascites, classes B and C; and 11 without ascites, class A); 42 with alcoholic steatohepatitis and 46 with alcoholic steatosis. The control group consisted of 32 healthy volunteers. Twelve-lead ECG recordings were performed and selected parameters were measured. RESULTS Significantly longer QT and QTc intervals and lower QRS voltage were found in patients with alcoholic and HCV cirrhosis compared to the controls. Significantly lower QRS voltage was found in subjects with ascites than in those without ascites. Removal of ascites significantly increased QRS voltage. CONCLUSIONS In cirrhosis, irrespective of etiology, ECG changes involved prolonged QT and QTc intervals and reduced QRS voltage. Prolonged QT and QTc intervals were not related to the severity of cirrhosis or to the presence of ascites. However, low QRS voltage was associated with the presence of ascites. Removal of ascites reverses low QRS voltage.
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Affiliation(s)
| | | | - Agnieszka Kowalik
- Department of Gastroenterology, Medical University of Lublin, Poland
| | - Emilia Lis
- Department of Gastroenterology, Medical University of Lublin, Poland
| | | | - Tomasz Lach
- Student of the Second Faculty of Medicine, Medical University of Lublin, Poland
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Sleptsova SS, Borisova NV. THE ROLE OF VIRAL HEPATITIS IN THE MECHANISM OF LIVER CANCER FORMATION AMONG THE FAR NORTH INDIGENOUS INHABITANTS. Wiad Lek 2015; 68:464-468. [PMID: 26887112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Yakutia is a region of high prevalence of viral hepatitis B, C and D. The rating and ranking of risk factors for the formation of cirrhosis and primary liver cancer in patients with chronic viral hepatitis (CVH) B, C and D in the Republic of Sakha (Yakutia) (R S(Y)), it is a serious medical problem. AIM Studying of the main reasons for the progression of chronic viral hepatitis B, C and D to cirrhosis and liver cancer in the Far North. MATERIALS AND METHODS Materials of official statistics of theTerritorial Rospotrebnadzor and official registration of the Ministry of Health of RS (Y); serological and molecular biological research methods to the studying of HCV genotype B, C, D. RESULTS On the basis of long-term morbidity of chronic viral hepatitis B, C and D and their outcomes in Yakutia defined a role in the progression to cirrhosis and primary liver cancer, ethnicity and genotype of HBV and HDV. Established fact of viral replication in cirrhosis and primary liver cancer under adverse social and environmental factors, genetically determined increased concentration of acetaldehyde due to impaired activity of alcohol dehydrogenases (ADH) and aldegiddegirogenases (AIDG) at the indigenous inhabitants of the republic proves the need for targeted therapy of complex events. CONCLUSIONS The regions of Yakutia are the most affected by the virus of hepatitis B, C and D with progressive course of the disease to cirrhosis and cirrhosis liver cancer, defined by genotype hepatitis B & D, in which significantly usually occurs primary liver cancer, also noted that the combined mixed-replicating virus hepatitis is a risk factor for primary liver cancer.
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Tokgöz Ö, Unal I, Turgut GG, Yildiz S. The value of liver and spleen ADC measurements in the diagnosis and follow up of hepatic fibrosis in chronic liver disease. Acta Clin Belg 2014; 69:426-32. [PMID: 25103596 DOI: 10.1179/2295333714y.0000000062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIMS To evaluate the value of spleen and liver apparent diffusion coefficients (ADC) in chronic liver disease patients, with and without hepatocellular carcinoma (HCC), and to investigate the use of diffusion-weighted imaging (DWI) in the diagnosis and follow-up of hepatic fibrosis. MATERIALS AND METHODS This study population comprised 68 chronic liver disease patients (Group 1) and 70 healthy volunteers as controls (Group 2). In Group 1, 40 patients had chronic hepatitis-B, 20 had chronic hepatitis-C, 5 had non-alcoholic steatohepatitis and 3 had alcoholic steatohepatitis. Diagnosis of chronic liver disease was made by percutaneous liver biopsy and the degree of fibrosis (stage) was determined using the METAVIR scoring system. HCC diagnosis was made with a lesion biopsy. The patient group was subdivided based on the degree of fibrosis (F1, F2, F3 and F4) and presence of HCC. After patient and control groups underwent b-value 600 s/mm(2) DWI examination, liver and spleen ADC values were mapped and measured. The ADC values of the patient groups (F1, F2, F3, F4; with HCC, without HCC) were compared with each other and with the control group. RESULTS Liver ADC values were lower in Group 1 compared to Group 2 (P<0·001). There was a statistically significant difference between the patient and control groups liver right lobe, left lobe and caudate lobe ADC values (P<0·001). Comparing the F1, F2, F3 and F4 groups, there was no statistically significant difference found in terms of ADC values (P>0·05). However, as degree of fibrosis increased there was a reduction in ADC values, though not statistically significant. Comparing the groups with HCC and without HCC, there was no statistically significant difference in ADC values (P>0·05). There was no statistical difference in average spleen ADC values between patient and control groups (P>0·05). CONCLUSIONS In chronic liver disease, ADC values were lower. As the degree of liver fibrosis increased, ADC levels decreased, though the relationship between ADC values and fibrosis degree was not statistically significant. Quantitative DWI may help in the diagnosis of fibrosis in chronic liver disease patients, however as it does not show the degree of fibrosis, its use in treatment planning and follow-up is controversial. Spleen DWI measurement is not a sufficient method to diagnose and determine the degree of fibrosis in chronic liver disease patients.
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Maiwall R, Goel A, Pulimood AB, Babji S, Sophia J, Prasad C, Balasubramanian KA, Ramakrishna B, Kurian S, Fletcher GJ, Abraham P, Kang G, Ramakrishna BS, Elias E, Eapen CE. Investigation into celiac disease in Indian patients with portal hypertension. Indian J Gastroenterol 2014; 33:517-23. [PMID: 25231910 DOI: 10.1007/s12664-014-0501-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 08/20/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND There is limited data on celiac disease in patients with cryptogenic cirrhosis or idiopathic noncirrhotic intrahepatic portal hypertension (NCIPH). Our objective was to evaluate for celiac disease in patients with portal hypertension in India. METHODS Consecutive patients with portal hypertension having cryptogenic chronic liver disease (cases) and hepatitis B- or C-related cirrhosis (controls) were prospectively enrolled. We studied tissue transglutaminase (tTG) antibody and duodenal histology in study patients. RESULT Sixty-one cases (including 14 NCIPH patients) and 59 controls were enrolled. Celiac disease was noted in six cases (including two NCIPH patients) as compared to none in controls. In a significant proportion of the remaining study subjects, duodenal biopsy showed villous atrophy, crypt hyperplasia, and lamina propria inflammation, not accompanied by raised intraepithelial lymphocytes (IELs); this was seen more commonly in cases as compared to controls. An unexpectedly high rate of tTG antibody positivity was seen in study subjects (66 %) of cases as compared to 29 % in controls (p-value < 0.001), which could indicate false-positive test result. CONCLUSION In this study, 10 % of patients with unexplained portal hypertension (cryptogenic chronic liver disease) had associated celiac disease. In addition, an unexplained enteropathy was seen in a significant proportion of study patients, more so in patients with cryptogenic chronic liver disease. This finding warrants further investigation.
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Affiliation(s)
- Rakhi Maiwall
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, 632 004, India
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Abstract
Cryptogenic cirrhosis is a clinical entity which has the potential for better diagnosis of actual underlying maladies with future advancements in medicine. Current understanding of CC is rapidly undergoing transformation (Figures 1 & 2). In the light of available evidence of frequent disappearance of fat in NASH-associated cirrhosis, CC explants showing steatosis, allografts demonstrating the full blown recurrence of NASH in CC, and the association of CC with diabetes and obesity, suggests CC to be more proximately linked with NAS than believed until now (Figure 2). However, there are subsets of patients within CC that appear to emerge from other etiologies. With increasing clarity of NASH pathogenesis, a useful biomarker might soon be available. Advancements in diagnostics and our understanding of NASH are likely to elucidate NASH-associated cirrhosis as the predominant cause of cryptogenic cirrhosis.
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25
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Darji ZJ, Chaudhari KS. Chronic active hepatitis--rare association with secondary eosinophilia. J Assoc Physicians India 2014; 62:363-364. [PMID: 25327050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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26
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Rigatti SJ. Response after treatment for advanced hepatitis C--a mortality abstract. J Insur Med 2014; 44:152-157. [PMID: 25622386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article presents an analysis of a recently published study of the survival experience among a group of patients treated for hepatitis C with advanced hepatic fibrosis/cirrhosis, divided into groups based on whether or not sustained virological response was achieved. The purpose is to evaluate the magnitude of excess mortality relative to a comparison population. The potential errors inherent in generating mock age/sex distributions from limited published data are also highlighted.
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27
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Chen YK, Yan XF. [Anti-tuberculosis therapy in patients with liver diseases and tuberculosis]. Zhonghua Jie He He Hu Xi Za Zhi 2013; 36:769-771. [PMID: 24433807] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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28
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Barashi N, Weiss ID, Wald O, Wald H, Beider K, Abraham M, Klein S, Goldenberg D, Axelrod J, Pikarsky E, Abramovitch R, Zeira E, Galun E, Peled A. Inflammation-induced hepatocellular carcinoma is dependent on CCR5 in mice. Hepatology 2013; 58:1021-30. [PMID: 23526353 DOI: 10.1002/hep.26403] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Accepted: 03/15/2013] [Indexed: 12/12/2022]
Abstract
UNLABELLED Human hepatocellular carcinoma (HCC) is an inflammation-induced cancer, which is the third-leading cause of cancer mortality worldwide. We investigated the role of the chemokine receptors, CCR5 and CCR1, in regulating inflammation and tumorigenesis in an inflammation-induced HCC model in mice. Multidrug resistance 2 gene (Mdr2)-knockout (Mdr2-KO) mice spontaneously develop chronic cholestatic hepatitis and fibrosis that is eventually followed by HCC. We generated two new strains from the Mdr2-KO mouse, the Mdr2:CCR5 and the Mdr2:CCR1 double knockouts (DKOs), and set out to compare inflammation and tumorigenesis among these strains. We found that in Mdr2-KO mice lacking the chemokine receptor, CCR5 (Mdr2:CCR5 DKO mice), but not CCR1 (Mdr2:CCR1 DKO), macrophage recruitment and trafficking to the liver was significantly reduced. Furthermore, in the absence of CCR5, reduced inflammation was also associated with reduced periductal accumulation of CD24(+) oval cells and abrogation of fibrosis. DKO mice for Mdr2 and CCR5 exhibited a significant decrease in tumor incidence and size. CONCLUSIONS Our results indicate that CCR5 has a critical role in both the development and progression of liver cancer. Therefore, we propose that a CCR5 antagonist can serve for HCC cancer prevention and treatment.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B/deficiency
- ATP Binding Cassette Transporter, Subfamily B/genetics
- ATP Binding Cassette Transporter, Subfamily B/physiology
- Animals
- Carcinoma, Hepatocellular/epidemiology
- Carcinoma, Hepatocellular/etiology
- Carcinoma, Hepatocellular/physiopathology
- Chemokine CCL5/physiology
- Disease Models, Animal
- Disease Progression
- Hepatitis, Chronic/complications
- Hepatitis, Chronic/genetics
- Incidence
- Liver/pathology
- Liver/physiopathology
- Liver Cirrhosis/complications
- Liver Cirrhosis/genetics
- Liver Neoplasms/epidemiology
- Liver Neoplasms/etiology
- Liver Neoplasms/physiopathology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Receptors, CCR1/deficiency
- Receptors, CCR1/genetics
- Receptors, CCR1/physiology
- Receptors, CCR5/deficiency
- Receptors, CCR5/genetics
- Receptors, CCR5/physiology
- ATP-Binding Cassette Sub-Family B Member 4
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Affiliation(s)
- Neta Barashi
- Goldyne Savad Institute of Gene Therapy, Human Biology Research Center, Hadassah Hebrew University Hospital, Jerusalem, Israel
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Potikha T, Stoyanov E, Pappo O, Frolov A, Mizrahi L, Olam D, Shnitzer-Perlman T, Weiss I, Barashi N, Peled A, Sass G, Tiegs G, Poirier F, Rabinovich GA, Galun E, Goldenberg D. Interstrain differences in chronic hepatitis and tumor development in a murine model of inflammation-mediated hepatocarcinogenesis. Hepatology 2013; 58:192-204. [PMID: 23423643 DOI: 10.1002/hep.26335] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 02/10/2013] [Indexed: 02/06/2023]
Abstract
UNLABELLED Chronic inflammation is strongly associated with an increased risk for hepatocellular carcinoma (HCC) development. The multidrug resistance 2 (Mdr2)-knockout (KO) mouse (adenosine triphosphate-binding cassette b4(-/-) ), a model of inflammation-mediated HCC, develops chronic cholestatic hepatitis at an early age and HCC at an adult age. To delineate factors contributing to hepatocarcinogenesis, we compared the severity of early chronic hepatitis and late HCC development in two Mdr2-KO strains: Friend virus B-type/N (FVB) and C57 black 6 (B6). We demonstrated that hepatocarcinogenesis was significantly less efficient in the Mdr2-KO/B6 mice versus the Mdr2-KO/FVB mice; this difference was more prominent in males. Chronic hepatitis in the Mdr2-KO/B6 males was more severe at 1 month of age but was less severe at 3 months of age in comparison with age-matched Mdr2-KO/FVB males. A comparative genome-scale gene expression analysis of male livers of both strains at 3 months of age revealed both common and strain-specific aberrantly expressed genes, including genes associated with the regulation of inflammation, the response to oxidative stress, and lipid metabolism. One of these regulators, galectin-1 (Gal-1), possesses both anti-inflammatory and protumorigenic activities. To study its regulatory role in the liver, we transferred the Gal-1-KO mutation (lectin galactoside-binding soluble 1(-/-) ) from the B6 strain to the FVB strain, and we demonstrated that endogenous Gal-1 protected the liver against concanavalin A-induced hepatitis with the B6 genetic background but not the FVB genetic background. CONCLUSION Decreased chronic hepatitis in Mdr2-KO/B6 mice at the age of 3 months correlated with a significant retardation of liver tumor development in this strain versus the Mdr2-KO/FVB strain. We found candidate factors that may determine strain-specific differences in the course of chronic hepatitis and HCC development in the Mdr2-KO model, including inefficient anti-inflammatory activity of the endogenous lectin Gal-1 in the FVB strain.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B/deficiency
- ATP Binding Cassette Transporter, Subfamily B/genetics
- Animals
- Carcinoma, Hepatocellular/etiology
- Carcinoma, Hepatocellular/pathology
- Cell Transformation, Neoplastic/pathology
- Chemical and Drug Induced Liver Injury/prevention & control
- Concanavalin A
- Galectin 1/physiology
- Hepatitis, Chronic/complications
- Hepatitis, Chronic/etiology
- Hepatitis, Chronic/pathology
- Liver/metabolism
- Liver Neoplasms/etiology
- Liver Neoplasms/pathology
- Male
- Methionine Adenosyltransferase/biosynthesis
- Mice
- Mice, Inbred Strains/genetics
- Mice, Knockout
- ATP-Binding Cassette Sub-Family B Member 4
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Affiliation(s)
- Tamara Potikha
- Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Iskra NI, Shatrova KM, Hur"iev SO, Kuz'min VI, Roshchin HH, Pleskach OI. [Assessment of functional activity of phagocytic system in patients suffered from Dupuytren's contracture with hepatic fibrosis]. Lik Sprava 2013:7-12. [PMID: 25095677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Dupuytren's contracture--a pathology that should not be seen as an isolated lesion tendon-aponeurotic structures of the palmar surface of the hand, but as a disease that requires careful research and a comprehensive, differentiated approach to treatment. The aim of the study was to investigate the functional activity of the phagocytic system of Dupuytren's contracture patients with chronic hepatitis and liver fibrosis in liquidators of the CHNPP accident consequences. The resulting study 188 patients aged 45-65 years showed the correlation of the data of the functional activity of phagocytic system with degree of liver fibrosis, thus objectively assess the patient's condition and make the appropriate correction in the diagnostic criteria as well as in medical and rehabilitative programs.
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31
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Iskra NI, Shatrova KM, Hur'iev SO, Kuz'min VI, Roshchin HH. [Morphological changes in hepatic tissues in patients, suffering Dupuytren's contracture and chronic hepatitis]. Klin Khir 2013:15-19. [PMID: 23705474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The results of morphological investigation of hepatic tissues in 98 patients, suffering contracture of Dupuytren, chronic hepatitis and hepatic fibrosis stages I, II i III, were adduced. The patients were operated on for calculous cholecystitis. The attempt to organize the groups with certain morphological changes, depending on the hepatic pathological process persistence (up to 5 yrs, from 5 to 10 yrs, over 10 yrs) have appeared nonfair. The changes revealed are too different and characteristic not only for the examined patients.
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32
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Abdurakhmanov DT. [Antiviral therapy and risk for hepatocellular carcinoma in chronic viral hepatitis]. TERAPEVT ARKH 2013; 85:94-97. [PMID: 24437226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hepatocellular carcinoma (HCC) is one of the most common human malignancies in incidence and mortality, which develops in the majority of patients in the stage of cirrhosis. Because of the major etiological role of hepatitis viruses, the prevention of HCC is vaccination against hepatitis B virus and successful antiviral therapy for chronic hepatitis B and C.
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MESH Headings
- Antiviral Agents/therapeutic use
- Carcinoma, Hepatocellular/epidemiology
- Carcinoma, Hepatocellular/etiology
- Global Health
- Hepatitis, Chronic/complications
- Hepatitis, Chronic/drug therapy
- Hepatitis, Chronic/epidemiology
- Hepatitis, Viral, Human/complications
- Hepatitis, Viral, Human/drug therapy
- Hepatitis, Viral, Human/epidemiology
- Humans
- Incidence
- Liver Neoplasms/epidemiology
- Liver Neoplasms/etiology
- Risk Factors
- Survival Rate/trends
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33
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Liu CH. The treatment of liver fibrosis. Zhonghua Gan Zang Bing Za Zhi 2012; 20:573-575. [PMID: 23227532] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Cheng-hai Liu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Caliskan Y, Yelken B, Ozkok A, Gorgulu N, Yazici H, Telci A, Yildiz A. Lower serum prohepcidin levels associated with lower iron and erythropoietin requirements in hemodialysis patients with chronic hepatitis C. BMC Nephrol 2012; 13:56. [PMID: 22768976 PMCID: PMC3496582 DOI: 10.1186/1471-2369-13-56] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 06/21/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with chronic HCV infection have increased liver iron. Recently identified protein hepcidin synthesized in the liver, is thought to be a key regulator for iron homeostasis and is induced by infection and inflammation. Lower erythropoietin and iron supplementation requirements were previously reported in HD patients with HCV infection. We investigated the association of prohepcidin with inflammation and iron parameters in HD patients with and without chronic HCV infection. METHODS Sixty patients (27 male, 33 female, mean age 50±15 years) on chronic HD were included. Parameters related to iron metabolism (ferritin, serum iron and total iron binding capacity (TIBC)), inflammation (hs-CRP, TNF-α and IL-6) and prohepcidin levels were measured. The response to treatment (erythropoiesis-stimulating agent (ESA) resistance index) was assessed from the ratio of the weekly erythropoietin (rhuEPO) dose to hemoglobin (Hb) per unit weight. RESULTS Serum prohepcidin levels of HCV positive patients (135±25 ng/mL) were significantly lower than HCV negative patients [148±18 ng/mL, (p=0.025)]. Serum IL-6 levels of HCV positive patients were also significantly lower than HCV negative patients (p=0.016). Serum prohepcidin levels were positively correlated with ferritin (r=0.405, p=0.001) and IL-6 (r=0.271, p=0.050) levels in HD patients. In the HCV positive group, serum prohepcidin levels significantly correlated with ferritin levels (r=0.514 p=0.004). In the HCV negative group, serum prohepcidin levels significantly correlated with serum IL-6 levels (r=0.418, p=0.027). In multiple regression analysis performed to predict prohepcidin in HCV positive patients, serum ferritin was found to be an independent variable (r=0.28, p=0.008). CONCLUSIONS HCV positive HD patients have low levels of serum prohepcidin and IL-6 which might account for iron accumulation together with lower iron and rhuEPO requirements in these patients.
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Affiliation(s)
- Yasar Caliskan
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Berna Yelken
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Abdullah Ozkok
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Numan Gorgulu
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Halil Yazici
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aysegul Telci
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alaattin Yildiz
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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35
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Begezsán II, Bejan C, Ghibu L, Dorobăt CM, Roşu F. Infective endocarditis in non-HIV immunosuppressed patients. Rev Med Chir Soc Med Nat Iasi 2012; 116:687-691. [PMID: 23272511] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Infective endocarditis is a septic illness with sudden or insidious onset that causes heart lesions or aggravates the preexisting ones; during its course it can affect other organs, mortality being high. AIM To identify non-HIV immunosuppressed patients with infective endocarditis, namely those with associated diabetes, hepatitis, cancer, or old age with multiple comorbidities, and to assess the nosocomial risk by Carmeli score. MATERIAL AND METHODS This is a retrospective study using epidemiological, clinical, laboratory and treatment data from 56 patients admitted to and diagnosed with infective endocarditis at the lasi Infectious Diseases Hospital in the interval January 2008 - May 2012. To these patients we looked for non-HIV immunosuppressed character, having in their pathology association diabetes, chronic hepatitis, malignancy, or other comorbidities. RESULTS From the infective endocarditis patients, 92.8% were found non-HIV immunosuppressed, 25% of them presenting renal failure, and 21.1% having diabetes. The most common Carmeli score obtained was score 2 in 57.1% of the cases. In these patients, the most frequent etiologic agent of infective endocarditis was Enterococcus faecalis (16%), followed by Staphylococcus aureus (10.7%). CONCLUSIONS It was noted that in addition to endocardial damage due to the multiple etiologic agents involved, non-HIV immunosuppression in these patients plays an important role. The association of Carmeli score in patients diagnosed with infective endocarditis is significant, especially in case of adequate therapy initiation for a right treatment of this pathology.
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Yano T, Okamoto T. [Chest surgery in patients with liver disease]. Kyobu Geka 2012; 65:734-737. [PMID: 22868438] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although surgery is contraindicated in patients with acute hepatic disorders such as acute hepatitis and acute liver failure, elective surgery might be well tolerated to the patients with non-cirrhotic liver diseases. Operative risk in patients with liver cirrhosis correlates with the severity of liver damage. Several well-known scoring systems for the assessment of cirrhotic severity such as Child-Pugh classification might be useful for the risk prediction in major abdominal surgery. However, there were few data concerning the risk prediction for general non-cardiac thoracic surgery. Clinical manifestations due to liver cirrhosis including hypoalbuminemia, bleeding tendency, ascites, infection, encephalopathy, should be thoroughly evaluated and optimally treated during perioperative period. Furthermore, careful intraoperative procedures are needed for both hemostasis and wound healing.
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Affiliation(s)
- T Yano
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
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Villar S, Ortiz-Cuaran S, Abedi-Ardekani B, Gouas D, Nogueira da Costa A, Plymoth A, Khuhaprema T, Kalalak A, Sangrajrang S, Friesen MD, Groopman JD, Hainaut P. Aflatoxin-induced TP53 R249S mutation in hepatocellular carcinoma in Thailand: association with tumors developing in the absence of liver cirrhosis. PLoS One 2012; 7:e37707. [PMID: 22675488 PMCID: PMC3366967 DOI: 10.1371/journal.pone.0037707] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 04/23/2012] [Indexed: 01/26/2023] Open
Abstract
Primary Liver Cancer (PLC) is the leading cause of death by cancer among males in Thailand and the 3rd among females. Most cases are hepatocellular carcinoma (HCC) but cholangiocarcinomas represent between 4 and 80% of liver cancers depending upon geographic area. Most HCC are associated with chronic infection by Hepatitis B Virus while a G→T mutation at codon 249 of the TP53 gene, R249S, specific for exposure to aflatoxin, is detected in tumors for up to 30% of cases. We have used Short Oligonucleotide Mass Analysis (SOMA) to quantify free circulating R249S-mutated DNA in plasma using blood specimens collected in a hospital case:control study. Plasma R249S-mutated DNA was detectable at low concentrations (≥67 copies/mL) in 53 to 64% of patients with primary liver cancer or chronic liver disease and in 19% of controls. 44% of patients with HCC and no evidence of cirrhosis had plasma concentrations of R249S-mutated DNA ≥150 copies/mL, compared to 21% in patients with both HCC and cirrhosis, 22% in patients with cholangiocarcinoma, 12% in patients with non-cancer chronic liver disease and 3% of subjects in the reference group. Thus, plasma concentrations of R249S-mutated DNA ≥150 copies/mL tended to be more common in patients with HCC developing without pre-existing cirrhosis (p = 0.027). Overall, these results support the preferential occurrence of R249S-mutated DNA in HCC developing in the absence of cirrhosis in a context of HBV chronic infection.
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MESH Headings
- Adult
- Aflatoxins/adverse effects
- Aged
- Amino Acid Substitution/genetics
- Carcinoma, Hepatocellular/blood
- Carcinoma, Hepatocellular/chemically induced
- Carcinoma, Hepatocellular/complications
- Carcinoma, Hepatocellular/genetics
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/pathology
- DNA, Neoplasm/blood
- Female
- Geography
- Hepatitis B Surface Antigens/immunology
- Hepatitis C Antibodies/immunology
- Hepatitis, Chronic/blood
- Hepatitis, Chronic/complications
- Hepatitis, Chronic/immunology
- Humans
- Liver Cirrhosis/blood
- Liver Cirrhosis/complications
- Liver Neoplasms/blood
- Liver Neoplasms/chemically induced
- Liver Neoplasms/complications
- Liver Neoplasms/genetics
- Male
- Middle Aged
- Mutation/genetics
- Thailand
- Tumor Suppressor Protein p53/genetics
- alpha-Fetoproteins/metabolism
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Affiliation(s)
| | | | | | - Doriane Gouas
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | | | | | - Marlin D. Friesen
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - John D. Groopman
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Pierre Hainaut
- International Agency for Research on Cancer, Lyon, France
- International Prevention Research Institute, Lyon, France
- * E-mail:
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Al-Dahshan M. Clinical application of transient elastography in prediction of portal hypertension related complication in patients with chronic liver diseases. J Egypt Soc Parasitol 2012; 42:79-88. [PMID: 22662598 DOI: 10.12816/0006297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Liver cirrhosis (LC) is the final evaluative stage of chronic liver diseases with dynamic progressive process to multiple complications especially splenomegaly and esophageal varices(EV). Efforts have been made to develop non-invasive predictive models that may correlate with LC and EV. The role of liver stiffness measurement (LSM)- and spleen stiffness measurement (SSM) by transient elastography (TE) in the diagnosis of LC and prediction of EV was studied on 90 subjects selected from the outpatient clinics of Bakhash Hospitals. They were classified into three groups: GI included 10 healthy volunteers as a control group, GII included 20 chronic hepatitis (CH) patients and GIII included 60 cirrhotic patients. Patients in GIII were further subdivided equally into two subgroups A & B according to presence or absence of EV. GIII patients were evaluated by gastroscope for screening and grading of EV. All groups were subjected to complete blood picture, liver and kidney function testes and abdominal ultrasonography as well as LSM (right lobe) and SSM by using fibroscan. LS were significantly higher in LC patients as compared with CH patients and controls. At a cutoff value of 9.8 kPa, sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for LC were 90%, 73%, 55% &78% respectively. At a cutoff value of 17.75 kPa (no varices vs. varices at any grade), sensitivity, specificity, PPV & NPV for prediction of EV were 92%, 46.2%, 73% & 67.2% respectively. LS at cut off values of 14.4 KPa predicted the splenomegaly. SSM at 50.4 KPa being the best cut-off value for prediction of varices with sensitivity, specificity, PPV, NPV & accuracy were 81.2%, 73.2%, 88.7%, 48.8% & 79.4% respectively. Combination of LS >17 KPa & SS > 52, predicted EV with 87.6% diagnostic accuracy. As regard EV prediction, combination of LSM & SSM had a highest diagnostic accuracy than PSR (76.9% vs. 87.6).
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Affiliation(s)
- Magdy Al-Dahshan
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo, Egypt
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Şımşek H, Pinar A, Altinbaş A, Alp A, Balaban YH, Büyükaşik Y, Özcebe O, Hasçelık G, Gedıkoğlu G, Tatar G. Alpha-1 antitrypsin deficiency in patients with chronic hepatitis. Turk J Gastroenterol 2012; 23:569-573. [PMID: 23161303] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIMS Alpha-1 antitrypsin deficiency causes accumulation of mutant alpha-1 antitrypsin molecules in hepatocytes, and is attributed to severe liver injury even in heterozygous state. However, there is a question as to whether alpha-1 antitrypsin deficiency is only a cause of liver injury or has a worsening effect on the underlying liver disease. We aimed to determine the role of alpha-1 antitrypsin deficiency in the ongoing chronic hepatitic process. MATERIALS AND METHODS Fifty-four patients with the diagnosis of chronic hepatitis by liver biopsy (36 chronic hepatitis B virus, 8 chronic hepatitis C virus, 7 non-alcoholic steatohepatitis, 2 primary biliary cirrhosis, and 1 autoimmune hepatitis) and 51 age- and sex-matched control subjects chosen from among healthy blood donors were included in the study. Isoelectric focusing for identifying alpha-1 antitrypsin phenotypes was performed in all patients and control subjects, whereas the histopathological examination was done only in patients. RESULTS Alpha-1 antitrypsin-deficient variant was absent in patients and controls. The mean serum alpha-1 antitrypsin level was significantly lower in patients (157.4 ± 33 mg/dl) than controls (134.8 ± 30 mg/dl) (p<0.00). Histological activity index and fibrosis grade in the liver were not related to the serum alpha-1 antitrypsin level (p: 0.276 and 0.902, respectively). Additionally, the serum alpha-1 antitrypsin levels among normal variants of alpha-1 antitrypsin did not differ according to the underlying liver diseases (p: 0.928). CONCLUSIONS This prospective case-control study could not define any additional effect of alpha-1 antitrypsin deficiency on liver histopathology in chronic hepatitis patients.
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Affiliation(s)
- Halis Şımşek
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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Iskra NI, Shatrova KM, Hur'iev SO, Kukuruz IS. [Morphological criteria of the operative tactics substantiation in Dupuytren's contracture in patients with chronic hepatitis]. Klin Khir 2011:66-68. [PMID: 22168030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The results of morphological investigations of the palms tissues in the patients, suffering Dupuytren's contracture (DC) and in whom chronic hepatitis was diagnosed, are adduced. The patients were divided on three groups, depending on the hepatic fibrosis grade present. Determination of morphological changes in various stages in patients, suffering hepatic fibrosis stage one and lasting up to 5 years, witnesses the possibility of the DC recurrence and its severity enhancement. The authors stress the necessity of morphological investigations conduction with the objective to determine the hepatic fibrosis grade while surgical intervention planning.
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O'Leary JG, Landaverde C, Jennings L, Goldstein RM, Davis GL. Patients with NASH and cryptogenic cirrhosis are less likely than those with hepatitis C to receive liver transplants. Clin Gastroenterol Hepatol 2011; 9:700-704.e1. [PMID: 21570483 PMCID: PMC4408909 DOI: 10.1016/j.cgh.2011.04.007] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [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: 11/17/2010] [Revised: 03/30/2011] [Accepted: 04/05/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Many patients with cryptogenic cirrhosis (CC) have other conditions associated with nonalcoholic steatohepatitis (NASH) that put them at risk for complications that preclude orthotopic liver transplantation (OLT). METHODS We followed all patients with NASH and CC who were evaluated for OLT (n = 218) at Baylor Simmons Transplant Institute between March 2002 and May 2008. Data were compared with those from patients evaluated for OLT because of hepatitis C virus (HCV)-associated cirrhosis (n = 646). RESULTS Patients with NASH and CC were older, more likely to be female, had a higher body mass index, and a greater prevalence of diabetes and hypertension, compared with patients with HCV-associated cirrhosis, but the 2 groups had similar model for end-stage liver disease (MELD) scores. NASH and CC in patients with MELD scores ≤15 were less likely to progress; these patients were less likely to receive OLT and more likely to die or be taken off the wait list because they were too sick, compared with patients with HCV-associated cirrhosis. The median progression rate among patients with NASH and CC was 1.3 MELD points per year versus 3.2 MELD points per year for the HCV group (P = .003). Among patients with MELD scores >15, there were no differences among groups in percentage that received transplants or rate of MELD score progression. Hepatocellular carcinoma occurred in 2.7% of patients with NASH and CC per year, compared with 4.7% per year among those with HCV-associated cirrhosis. CONCLUSIONS Patients with NASH and CC and low MELD scores have slower disease progression than patients with HCV-associated cirrhosis and are less likely to receive OLT.
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Affiliation(s)
- Jacqueline G O'Leary
- Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, USA.
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42
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Fomenko OZ, Ushakova HO, Piierzhynovs'kyĭ SH. [Astroglia proteins in the rat brain in experimental chronic hepatitis and 2-oxoglutarate effect]. Ukr Biokhim Zh (1999) 2011; 83:69-76. [PMID: 21800651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A probable increase of the level of calcium-binding protein S100b and soluble form of glial fibrillary acidic protein (GFAP), as well as reducing the level of filament GFAP in the brain of Wistar rats under hepatic encephalopathy development caused by chronic hepatitis (HP) were shown. Increasing concentrations of S100b may stimulate the disassembly of intermediate filaments of astrocytes. The immunohistochemical analysis helps to reveal that astrocytes in the brain of rats that had HP lose the characteristic stellate shape and swelling. Immunoblotting result have shown the fragmentation of the main filament form of GFAP and appearance of low mass derivates. Application of 2-oxoglutarate (2.28 g/l of drinking water during 10 days after the onset of chronic hepatitis) stabilized the studied proteins and the state of astroglia.
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43
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Lee HS, Kim JK, Cheong JY, Han EJ, An SY, Song JH, Jung YJ, Jeon SC, Jung MW, Jang EJ, Cho SW. Prediction of compensated liver cirrhosis by ultrasonography and routine blood tests in patients with chronic viral hepatitis. Korean J Hepatol 2010; 16:369-75. [PMID: 21415580 PMCID: PMC3304612 DOI: 10.3350/kjhep.2010.16.4.369] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 10/14/2010] [Accepted: 10/29/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIMS Liver biopsy is a standard method for diagnosis of liver cirrhosis in patients with chronic hepatitis. Because liver biopsy is an invasive method, non-invasive methods have been used for diagnosis of compensated liver cirrhosis in patients with chronic hepatitis. The current study was designed to evaluate the usefulness of ultrasonography and routine blood tests for diagnosis of compensated liver cirrhosis in patients with chronic viral hepatitis. METHODS Two hundred three patients with chronic viral hepatitis who underwent liver biopsy were included in this study and ultrasonography and routine blood tests were analyzed retrospectively. Ultrasonographic findings, including surface nodularity, parenchyma echogenecity, and spleen size, were evaluated. The diagnostic accuracy of ultrasonography and routine blood tests were examined. RESULTS Discriminant analysis with forward stepwise selection of variables showed that liver surface nodularity, platelet count, and albumin level were independently associated with compensated liver cirrhosis (p<0.05). Cross-tabulation revealed that the following 4 variables had >95% specificity: platelet count <100,000 /uL; albumin level <3.5 g/dL; INR >1.3; and surface nodularity. If at least one of the four variables exists in a patient with chronic viral hepatitis, we can predict liver cirrhosis with 90% specificity and 61% sensitivity. CONCLUSIONS These results suggest that four variables (platelet count <100,000 /uL, albumin level <3.5 g/dL, INR >1.3, and surface nodularity) can be used for identification of liver cirrhosis in patients with chronic viral hepatitis with high specificity.
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Affiliation(s)
- Hong Sub Lee
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Jai Keun Kim
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Youn Cheong
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Eun Jin Han
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - So-Yeon An
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Jun Ha Song
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Yun Jung Jung
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Sung Chan Jeon
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Min Wook Jung
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Eun-Jung Jang
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Sung Won Cho
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
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Hjøllund NH. [Depression and fatigue in chronic disease]. Ugeskr Laeger 2010; 172:2633; author reply 2633. [PMID: 20931735] [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: 05/30/2023]
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Jain D, Nayak NC, Saigal S. Hepatocellular carcinoma arising in association with von-Meyenburg's complexes: an incidental finding or precursor lesions? A clinicopatholigic study of 4 cases. Ann Diagn Pathol 2010; 14:317-20. [PMID: 20850692 DOI: 10.1016/j.anndiagpath.2010.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Accepted: 04/06/2010] [Indexed: 12/22/2022]
Abstract
Biliary hamartomas or von-Meyenburg complexes form part of a spectrum of ductal plate malformation that includes polycystic liver disease, congenital hepatic fibrosis, and Caroli disease. These lesions are known to have neoplastic transformation. Development of intrahepatic cholangiocarcinoma is well described in these complexes. Rarely, hepatocellular carcinomas (HCCs) have been seen in association with bile duct hamartomas, however; it is not clear whether development of HCC is an epiphenomenon unrelated to the precursor lesion or biliary hamartomas may progress to liver cancers. We herein report 4 interesting cases of hepatitis C virus-, alcohol-, and nonalcoholic fatty liver disease-associated end-stage liver disease with coexisting HCC and multiple large von-Meyenburg complexes.
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Affiliation(s)
- Deepali Jain
- Department of Pathology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India.
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Hou Z, Tan D, Liu G, Xie Y, Li C, Xie J, Lu M, Liu Z, Sha X. Clinical characteristics and therapeutic analysis of invasive fungal infection in chronic severe hepatitis patients. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2010; 35:537-542. [PMID: 20622324 DOI: 10.3969/j.issn.1672-7347.2010.06.001] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To investigate clinical features and antifungal therapeutic effect of chronic severe hepatitis (CSH) patients with invasive fungal infection (IFI), and to improve the diagnosis and treatment. METHODS Clinical manifestation, blood routine, imageology and mycetology characteristic, antifungal treatment perscription and therapeutic effect of 79 CSH patients with IFI were retrospectively analyzed. Antifungal therapeutic effect was compared between fluconazole and voriconazole. RESULTS Thirteen (16.5%) patients received glucocorticoid or other immunodepressants for a relatively long time, 40 (50.6%) patients had invasive operation, and 61 (77.2 %) patients were administered 1-6 kinds of broad-spectrum antibiotics. Seventy-three patients had fever. Leucocytes and neutrophilic granulocyte increased in 96.2% of the patients. Lung (31.6%), intestinal tract (26.2%) and oral cavity (14%) infections were common. Fungus was found in 70.9% of the patients. Candida albicans (40.9%) and aspergillus (21.1%) were often seen. Halo signs and crescent signs on lung CT were relatively specific in 40% of the patients with fungal pneumonia. Voriconazole was more effective than fluconazole(71.4% vs. 39.0%, P<0.05). Twelve patients with lung aspergillus infection were administered voriconazole, 8 (66.7%) patients of whom was effective, and the other 4 (33.3%) patients died. CONCLUSION There are high risk factors in major CSH patients with IFI. The most common clinical manifestations of CSH patients with IFI are fever, leukocytosis, lung and intestinal tract infection. Candida albicans and aspergillus infection are common. Voriconazole is more effective than fluconazole, and can increase the survival rate of CSH patients with IFI.
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Affiliation(s)
- Zhouhua Hou
- Infectious Disease Research Institute, Xiangya Hospital, Central South University, Changsha 410008, China
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Cariello R, Federico A, Sapone A, Tuccillo C, Scialdone VR, Tiso A, Miranda A, Portincasa P, Carbonara V, Palasciano G, Martorelli L, Esposito P, Cartenì M, Del Vecchio Blanco C, Loguercio C. Intestinal permeability in patients with chronic liver diseases: Its relationship with the aetiology and the entity of liver damage. Dig Liver Dis 2010; 42:200-4. [PMID: 19502117 DOI: 10.1016/j.dld.2009.05.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 04/30/2009] [Accepted: 05/01/2009] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alteration in intestinal permeability may be an important factor in the pathogenesis of both the progression of some chronic liver diseases and the onset of some complications in patients with liver cirrhosis. AIMS To investigate the relationships between intestinal permeability, portal hypertension, alcohol use, plasma levels of pro-inflammatory cytokines, and nitric oxide, expressed as s-nitrosothiols, and nitrite levels in patients with various types and degrees of chronic liver diseases. METHODS 134 healthy volunteers and 83 patients with chronic liver damage entered the study. Intestinal permeability was assessed with the lactulose/mannitol test. Plasma levels of tumour necrosis factor-alpha, interleukin-6, and nitrite and total s-nitrosothiols were determined. RESULTS Intestinal permeability was altered in patients with advanced liver disease and impaired in 15-35% of patients without cirrhosis. Independent factors for intestinal permeability alteration were age, portal hypertension, alcohol use, and diabetes. Plasma levels of inflammatory cytokines and nitrosothiols were significantly higher in patients with altered intestinal permeability. CONCLUSIONS An intestinal permeability evaluation in patients with chronic liver diseases might clarify the significance of intestinal permeability in the pathophysiology of both the progression of liver damage, and the occurrence of complications that accompany liver cirrhosis.
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Affiliation(s)
- Rita Cariello
- Department of Experimental Medicine, Second University of Naples, Italy
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Chen R, Chen XP, Lin QQ, Lin BL, Cao HJ. [Detection of Helicobacter species related genes coding for 16S rRNA in the liver tissue of patients with chronic liver disease]. Nan Fang Yi Ke Da Xue Xue Bao 2010; 30:131-132. [PMID: 20118002] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the infection of Helicobacter pylori (Hp) in the liver tissue of patients with chronic liver disease and the association between Hp and chronic liver disease. METHODS Liver tissue samples were obtained by liver biopsy and surgical resection from 30 healthy subjects, 30 patients with chronic hepatitis, 30 with cirrhosis and 30 with liver cancer. All the samples were confirmed by pathological examination. The gene fragment coding for 16SrRNA were amplified by PCR with sequence analysis. RESULTS The PCR product of the 16SrRNA gene was 109 bp in length. Hp 16SrRNA was detected in 18 out of 30 liver biopsy samples from patients with primary cancer (60.0%), in 14 samples from patients with liver cirrhosis (47.0%), and in none of the samples from normal subjects or patients with chronic hepatitis. Sequencing analysis of Hp 16SrRNA gene in the liver tissue showed a 98.8% homology with the gene fragment encoding Hp 16SrRNA. CONCLUSION Hp is identified in the liver tissue of patients with chronic liver disease, suggesting the possible correlation between Hp infection and hepatocellular carcinoma.
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Affiliation(s)
- Ren Chen
- Department of Infectious Diseases, Guangdong Provincial People's Hospital , Guangzhou 510080, China.
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Hsieh YY, Tung SY, Lee IL, Lee K, Shen CH, Wei KL, Chang TS, Chuang CS, Wu CS, Lin YH. FibroQ: an easy and useful noninvasive test for predicting liver fibrosis in patients with chronic viral hepatitis. Chang Gung Med J 2009; 32:614-622. [PMID: 20035640] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Liver biopsy-the gold standard in assessing liver histology-is recommended before all antiviral treatment. However, this procedure may cause complications, is costly, and is limited by sampling errors. Hence, noninvasive tests have been proposed to assess the severity of hepatic fibrosis. We propose a novel noninvasive index for predicting liver fibrosis, named fibro-quotient (FibroQ), and compared the diagnostic accuracies of FibroQ, aspartate aminotransferase (AST)-to-platelet ratio index (APRI), and AST/alanine aminotransferase (ALT) ratio (AAR). METHODS This retrospective cohort study included 140 consecutive patients with chronic viral hepatitis who had undergone percutaneous liver biopsy before treatment at the Chang Gung Memorial Hospital, Chiayi from May 2005 through December 2007. The clinical data including sex, age, AST, ALT, platelet count, prothrombin time (PT) international normalized ratio (INR), and the Metavir fibrosis score (F0 to F4) of liver histology were recorded. APRI, AAR, and FibroQ were calculated. Receiver operating characteristic (ROC) curves were constructed to compare the accuracies of these three noninvasive tests in predicting significant fibrosis in patients with chronic viral hepatitis. RESULTS FibroQ performed better than APRI, but was equal to AAR, in the prediction of significant fibrosis [area under the receiver operating characteristic curve (AUC): 0.783 vs 0.631 (p = 0.02) and 0.783 vs 0.733 (p = 0.26), respectively] and cirrhosis (AUC: 0.791 vs 0.634 (p = 0.03), and 0.791 vs 0.782 (p= 0.47), respectively). Using FibroQ below the lower cutoff value (0.6) and above the higher cutoff value (1.6), 108 of 140 (77.1%) patients could be identified correctly to have or not have significant fibrosis. CONCLUSION FibroQ, a novel noninvasive test, is an useful and easy tool to evaluate liver fibrosis in patients with chronic viral hepatitis and has better accuracy than APRI and is equal to AAR. Further prospective studies are warranted to validate its efficacy.
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Affiliation(s)
- Yung-Yu Hsieh
- Department of Gastroenterolgy and Hepatology, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Alekseeva AS, Beloborodova EI, Rachkovskiy MI, Naumova EL, Lambrov EG, Philippova LP. Serotonin metabolism parameters in patients with chronic hepatitis and liver cirrhosis. Bull Exp Biol Med 2009; 146:577-9. [PMID: 19526095 DOI: 10.1007/s10517-009-0353-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We studied disorders in serotonin metabolism in patients with chronic hepatitis and cirrhosis of the liver with and without inflammatory process (cytolysis syndrome) and their impact for the formation of depressive disorders. Blood serotonin content decreased in patients with cirrhosis of the liver with pronounced depressive disorders. Serum serotonin level was elevated in all patients with the cytolysis syndrome.
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Affiliation(s)
- A S Alekseeva
- Department of Therapy, Faculty of Upgrading and Postgraduate Training of Physicians, Siberian State Medical University, Tomsk, Russia
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