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Mediterranean diet and nonalcoholic fatty liver disease

World Journal of Gastroenterology 2018年第19期24卷 2083-2094页

作者： Caterina Anania Francesco Massimo Perla Francesca Olivero Lucia Pacifico Claudio Chiesa Policlinico Umberto I Hospital Sapienza University of Rome Institute of Translational Pharmacology National Research Council

Nonalcoholic fatty liver disease(NAFLD) is emerging as the most common chronic liver disease, and is characterized by a wide spectrum of fat-liver disorders that can result in severe liver disease and cirrhosis. Inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. Currently, there is no consensus concerning the pharmacological treatment of NAFLD. However, lifestyle interventions based on exercise and a balanced diet for quality and quantity, are considered the cornerstone of NAFLD management. Mediterranean diet(MD), rich in polyunsaturated fats, polyphenols, vitamins and carotenoids, with their anti-inflammatory and antioxidant effects, has been suggested to be effective in preventing cardiovascular risk factors. In adults, MD has also been demonstrated to be efficacious in reducing the risk of metabolic syndrome. However, few studies are available on the effects of the MD in both adult and pediatric subjects with NAFLD. Thus, the aims of the present narrative review are to analyze the current clinical evidence on the impact of MD in patients with NAFLD, and to summarize the main mechanisms of action of MD components on this condition.

关键词： Mediterranean diet children Nonalcoholic fatty liver disease adults

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Immune response to vaccines in children with celiac disease

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World Journal of Gastroenterology 2017年第18期23卷 3205-3213页

作者： Caterina Anania Francesca Olivero Alessandra Spagnolo Claudio Chiesa Lucia Pacifico Policlinico Umberto I Sapienza University of Rome Department of Public Health and Infectious Diseases Sapienza University of Rome Institute of Translational Pharmacology National Research Council

Celiac disease(CD) is an immune-mediated systemic condition evoked by ingestion of gluten and related prolamines in genetically susceptible subjects. The disease is featured by a variable combination of clinical signs, specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. Vaccination is the most potent intervention for infectious disease prevention. Several factors including age, gender, ethnicity, quality and quantity of vaccine antigen, doses, and route of administration can influence immune response to vaccination, although the main cause of variation in the responsiveness among vaccine recipients is host genetic variability. The HLA system has a fundamental role in identifying the antigens introduced into the host with the vaccines and in the development of specific antibodies, and some HLA phenotypes have been associated with a less effective immunological response. The available literature indicates that the immunological response to vaccines in CD children does not differ markedly from that of general population and antibody titres are high enough to provide long-term protection, except for hepatitis B virus vaccine. In this article, we review and discuss the scarce literature in this field in order to provide clinical practice guidelines to achieve the most efficient monitoring of the response to vaccines in pediatric CD patients.

关键词：腹的疾病孩子感染疫苗肝炎 B 疫苗 HLA 面筋免费饮食

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Cardiometabolic risk factors in children with celiac disease on a gluten-free diet

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World Journal of Clinical Pediatrics 2017年第3期6卷 143-148页

作者： Caterina Anania Lucia Pacifico Francesca Olivero Francesco Massimo Perla Claudio Chiesa Policlinico Umberto Ⅰ Hospital Sapienza University of Rome Institute of Translational Pharmacology National Research Council

Celiac disease(CD) is an immune-mediated systemic condition evoked by gluten and related prolamines in genetically predisposed subjects. It is characterised by a variable combination of gluten-dependent clinical symptoms, CDspecific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. The only therapy of CD consists of a life-long gluten free diet(GFD). Strict GFD adherence results in full clinical, serological and histological remission, avoiding long-term complications in CD patients. However, this diet is not without problems. Gluten free products have high levels of lipids, sugar and salt to improve food palatability and consistency, and subjects with CD show an excessive consumption of hypercaloric and hyperlipidic foods to compensate dietetic restriction. GFD may therefore have a negative impact on cardiometabolic risk factors such as obesity, serum lipid levels, insulin resistance, metabolic syndrome, and atherosclerosis. In adults, some studies have suggested that GFD have a beneficial effect on cardiovascular profile, whereas others have shown an atherogenic effect of GFD. In children, very few studies are available on the issue. Thus, the aim of the present narrative review was to analyze the current clinical evidence on the impact of GFD on cardiometabolic risk factors in children with CD.

关键词： Celiac disease Children Gluten free diet Cardiometabolic risk Atherosclerosis

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