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Therapeutic application of stem cells in gastroenterology:An up-date

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World Journal of Gastroenterology 2011年第34期17卷 3870-3880页

作者： Patrizia Burra Debora Bizzaro Rachele Ciccocioppo Fabio Marra anna chiara piscaglia Laura Porretti Antonio Gasbarrini Francesco Paolo Russo Department of Surgical and Gastroenterological Sciences Gastroenterology Section University of Padua First Department of Internal Medicine IRCCS Policlinico San Matteo Foundation University of Pavia Department of Internal Medicine University of Florence Department of Internal Medicine Gemelli Hospital "Gastrointestinal and Liver Stem Cell Research Group" (GILSteR) Catholic University of Rome Center of Transfusion Medicine Cell Therapand Cryobiology IRCCS Fondazione Ospedale Maggiore Poli-clinico Mangiagalli e Regina Elena

Adult stem cells represent the self-renewing progenitors of numerous body tissues, and they are currently classified according to their origin and differentiation ability. In recent years, the research on stem cells has expanded enormously and holds therapeutic promises for many patients suffering from currently disabling diseases. This paper focuses on the possible use of stem cells in the two main clinical settings in gastro-enterology, i.e., hepatic and intestinal diseases, which have a strong impact on public health worldwide. Despite encouraging results obtained in both regenerative medicine and immunemediated conditions,further studies are needed to fully understand the biology of stem cellsand carefully assess their put ativeonco- ***,there searchonstemcellsarousesferventethical,***llsheldinVeronaduringtheⅩⅥCongressoftheFederationofItalianSocietiesofDigestiveDiseases(March 6-9,2010).Here,we report on the issues discussed,including liver and intestinal diseases that may benefit from stemcell therapy,the biology of hepatic and intestinal tissue repair,and stem cell usage inclinical trials.

关键词： Stem cells Cell therapy Regenerative medicine Liver disease Inflammatory bowel disease

WJSC 6^(th) Anniversary Special Issues(2):Mesenchymal stem cells Intestinal stem cells and celiac disease

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World Journal of Stem Cells 2014年第2期6卷 213-229页

作者： anna chiara piscaglia Endoscopy and Gastroenterology Unit State Hospital-Republic of San Marino

Stem cells(SCs)are the key to tissue genesis and *** their central role in homeostasis,dysfunctions of the SC compartment play a pivotal role in the development of cancers,degenerative disorders,chronic inflammatory pathologies and organ *** gastrointestinal tract is constantly exposed to harsh mechanical and chemical conditions and most of the epithelial cells are replaced every 3 to 5 *** to the so-called Unitarian hypothesis,this renewal is driven by a common intestinal stem cell(ISC)residing within the crypt base at the origin of the crypt-to-villus hierarchical migratory *** disease(CD)can be defined as a chronic immune-mediated disease that is triggered and maintained by dietary proteins(gluten)in genetically predisposed *** advances have been achieved over the last years in understanding of the pathogenic interactions among genetic,immunological and environmental factors in CD,with a particular emphasis on intestinal barrier and gut ***,little is known about ISC modulation and deregulation in active celiac disease and upon a gluten-free ***,bone marrow-derived SC transplantation has become an option for celiac patients with complicated or refractory *** manuscript summarizes the"state of the art"regarding CD and ISCs,their niche and potential role in the development and treatment of the disease.

关键词： Intestinal stem cells CD133 Lgr5 Celiac disease Paneth cells Gut microbiota Gut barrier

Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome?

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World Journal of Gastroenterology 2016年第46期22卷 10198-10209页

作者： anna chiara piscaglia Lucrezia Laterza Valentina Cesario Viviana Gerardi Rosario Landi Loris Riccardo Lopetuso Giovanni Calò Giovanna Fabbretti Massimo Brisigotti Maria Loredana Stefanelli Antonio Gasbarrini Endoscopy and Gastroenterology Unit Depatment of Internal Medicine State Hospital School of Gastroenterology Dept. of Internal Medicine and Gastroenterology "Gemelli" Hospital Catholic University Depatment of Pathology "Infermi" Hospital

AIM To evaluate the prevalence of nodular lymphoid hyperplasia(NLH) in adult patients undergoing colonoscopy and its association with known diseases. METHODS We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome(IBS)-type symptoms or suspected inflammatory bowel disease(IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer *** collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same *** One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals(only 3%), while it was significantly more prevalent in symptomatic cases(32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis. CONCLUSION About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients.

关键词： Inflammatory bowel diseases Functional gastrointestinal diseases Irritable bowel syndrome Colonoscopy Inflammation

Systematic review of surgical resection vs radiofrequency ablation for hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第26期19卷 4106-4118页

作者： Alessandro Cucchetti Fabio piscaglia Matteo Cescon Giorgio Ercolani Antonio Daniele Pinna General Surgery and Transplant Unit Department of General Surgery and Organ Transplantation Alma Mater Studiorum-University of Bologna Policlinico Sant'Orsola-Malpighi University of Bologna Division of Internal Medicine Department of Clinical Medicine S Orsola-Malpighi Hospital Alma Mater Studiorum-University of Bologna

Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation can not be offered or is not immediately accessible. Hepatic resection (HR) is currently considered the most curative strategy, but in the last decade local ablative therapies have started to obtain satisfactory results in term of efficacy and, of them, radiofrequency ablation (RFA) is considered the reference standard. An extensive literature review, from the year 2000, was performed, focusing on results coming from studies that directly compared HR and RFA. Qualities of the studies, characteristics of patients included, and patient survival and recurrence rates were analyzed. Except for three randomized controlled trials (RCT), most studies are affected by uncertain methodological approaches since surgical and ablated patients represent different populations as regards clinical and tumor features that are known to affect prognosis. Unfortunately, even the available RCTs report conflicting results. Until further evidences become available, it seems reasonable to offer RFA to very small HCC ( 2 cm and especially if > 3 cm, and/or in tumor locations in which ablation is not expected to be effective or safe, surgical removal is to be preferred.

关键词： Hepatocellular carcinoma Hepatic resection Surgical therapy Ablation techniques Survival Liver failure

Current guidelines for diagnosis and management of hepatic involvement in hereditary hemorrhagic teleangiectasia

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World Journal of Hepatology 2023年第5期15卷 675-687页

作者： Luca Ielasi Matteo Tonnini Fabio piscaglia Ilaria Serio Department of Medical and Surgical Sciences University of BolognaBologna 40138Italy Department of Internal Medicine Ospedale per gli Infermi di FaenzaFaenza 48018Italy Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy

Hereditary hemorrhagic teleangiectasia(HHT),also known as Rendu-Osler-Weber syndrome,is the most common cause of hepatic vascular malformations in *** vascular shunts(arteriovenous,arterioportal or portovenous)lead to different clinical *** though no hepatic-related symptoms are reported in the majority of cases,the severity of liver disease could lead to refractory medical conditions,in some cases requiring liver *** aim of this manuscript is to provide an updated overview of the current evidence regarding the diagnosis and treatment of HHT liver involvement and liver-related complications.

关键词： involvement diagnosis hemorrhagic

Direct oral anticoagulants for the treatment of splanchnic vein thrombosis:A state of art

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World Journal of Gastroenterology 2023年第33期29卷 4962-4974页

作者： Giovanni Monaco Luca Bucherini Bernardo Stefanini Fabio piscaglia Francesco Giuseppe Foschi Luca Ielasi Department of Medical and Surgical Sciences University of BolognaBologna 40138Italy Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Department of Internal Medicine Ospedale degli Infermi di FaenzaFaenza 48018Italy

Splanchnic vein thrombosis(SVT)is a manifestation of venous thromboembolism in an unusual ***,mesenteric,and splenic veins are the most common vessels involved in SVT which occurs mainly in patients with liver cirrhosis,although non-cirrhotic patients could be affected as *** of hepatic veins,also known as Budd-Chiari syndrome,is another manifestation of *** diagnosis and intervention are mandatory in order to increase the recalization rate and reduce the risk of thrombus progression and hypertensive *** anticoagulation with heparin and vitamin-K antagonists is the treatment of choice in these ***,recent studies have shown promising results on the efficacy and safety of direct oral anticoagulants(DOACs)in this *** results are mainly based on retrospective studies with small sample size,but first clinical trials have been published in the last *** manuscript aims to provide an updated overview of the current evidence regarding the role of DOACs for SVT in both cirrhotic and non-cirrhotic patients.

关键词： Splanchnic vein thrombosis Portal vein thrombosis Budd-Chiari syndrome Direct oral anticoagulants

The duration of the conventional chemoembolization for hepatocellular carcinoma:factors affecting the procedural time

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Hepatoma Research 2022年第1期8卷 313-326页

作者： Matteo Renzulli Mattia Gentilini Giovanni Marasco Nicolo Brandi Alessandro Granito Silvia Lo Monaco anna Maria Ierardi Antonio De Cinque Francesco Tovoli Laura Bartalena Daniele Spinelli Fabio piscaglia Rita Golfieri Department of Radiology IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Internal Medicine and Digestive Physiopathology Unit IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Division of Internal Medicine IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Diagnostic and Interventional Radiology Department Fondazione IRCCS CàGranda Ospedale Maggiore PoliclinicoUniversitàdegli Studi di Milano MilanMilan 20122Italy

Aim:The present study evaluated the duration of chemoembolization in patients with hepatocellular carcinoma,analyzing possible factors affecting the procedural ***:In total,175 patients who underwent chemoembolization have been prospectively *** procedural length was considered the time between the insertion and the removal of the angiographic *** features related to the tumor burden and angiographic procedures,which could be related to the procedural time,were ***:The chemoembolization time resulted in a mean of 58.1 *** longer procedural time was associated with a number of nodules treated per patient≥2(P<0.001),a number of segments with nodules≥2(P<0.001),the presence of more than 1 nodule in the same segment(P<0.001),the location of the tumor in the left lobe(P=0.001),the exclusion from the Milan criteria(P<0.001),and a number of segments treated≥2(P<0.001).Only the number of nodules treated per patient resulted significantly in multivariate analysis(OR 2.927,95%CI:2.015-4.251,P<0.001).Conclusion:The factors related to longer procedural time are the number of nodules treated≥2,the number of segments with nodules≥2,the involvement of the left lobe,the tumor burden outside the Milan criteria,and the number of segments treated≥*** these characteristics,known in the pre-procedural phase,represent useful tools for a correct planning of the angiographic room’s workflow during the pandemic era as well as in the future to reduce downtime and increase productivity.

关键词： Chemoembolization hepatocellular carcinoma procedural time angiographic room management

Hepatorenal syndrome: Update on diagnosis and treatment

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World Journal of Nephrology 2015年第5期4卷 511-520页

作者： Olga Baraldi chiara Valentini Gabriele Donati Giorgia Comai Vania Cuna Irene Capelli Maria Laura Angelini Maria Ilaria Moretti Andrea Angeletti Fabio piscaglia Gaetano La Manna Department of Experimental Diagnostic Specialty Medicine Nephrology Dialysis and Renal Transplant Unit S. Orsola University Hospital Division of Internal Medicine Department of Digestive Diseases and Internal Medicine Sant’Orsola-Malpighi Hospital University of Bologna

Acute kidney injury(AKI) is a common complication in patients with end-stage liver disease and advanced cirrhosis regardless of the underlying cause. Hepatorenal syndrome(HRS), a functional form of kidney failure, is one of the many possible causes of AKI. HRS is potentially reversible but involves highly complex pathogenetic mechanisms and equally complex clinical and therapeutic management. Once HRS has developed, it has a very poor prognosis. This review focuses on the diagnostic approach to HRS and discusses the therapeutic protocols currently adopted in clinical practice.

关键词： Hepatorenal syndrome Cirrhosis Acute kidney injury Diagnosis Treatment Terlipressin Liver support system