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Autoantibodies in chronic hepatitis C: A clinical perspective

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World Journal of Hepatology 2015年第8期7卷 1074-1085页

作者： janaína luz narciso-schiavon Leonardo de Lucca schiavon Department of Internal Medicine Gastroenterology Division Federal University of Santa Catarina

Non-organ-specific autoantibodies and thyroid autoantibodies have been frequently found in chronic carriers of hepatitis C virus(HCV). With respect to endomysial antibodies and tissue transglutaminase, it is controversial whether the prevalence of glutenrelated seromarkers is higher in patients with HCV. In such cases, in addition to acknowledging any currently existing autoimmune disease, recognizing the risk of the patient developing an autoimmune disease during interferon(IFN)-based treatment must be a principle concern. From a clinical point-of-view, the presence of autoantibodies arouses suspicion that an autoimmunedisease may be present or may be precipitated by IFNbased HCV treatment. In this paper, we review the prevalence of autoantibodies in individuals with hepatitis C, the clinical significance of these autoantibodies, and the approach recommended for such situations.

关键词： Hepatitis C Autoimmunity Antibodies Antinuclear Hepatitis Autoimmune Thyroid diseases Hashimoto disease Thyroglobulin Celiac disease Transglutaminases Diarrhea Interferon-alpha

Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

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World Journal of Gastroenterology 2014年第11期20卷 2854-2866页

作者： Leonardo de Lucca schiavon janaína luz narciso-schiavon Roberto José de Carvalho-Filho Gastroenterology Division Department of Internal MedicineFederal University of Santa CatarinaFlorianópolisSC 88040-900Brazil Gastroenterology Division Department of MedicineFederal University of Sao PauloSao PauloSP 04023-900Brazil

Assessment of liver fibrosis in chronic hepatitis C virus(HCV)infection is considered a relevant part of patient care and key for decision *** liver biopsy has been considered the gold standard for staging liver fibrosis,it is an invasive technique and subject to sampling errors and significant intra-and inter-observer *** the last decade,several noninvasive markers were proposed for liver fibrosis diagnosis in chronic HCV infection,with variable *** the clear advantage of being noninvasive,a more objective interpretation of test results may overcome the mentioned intra-and inter-observer variability of liver *** addition,these tests can theoretically offer a more accurate view of fibrogenic events occurring in the entire liver with the advantage of providing frequent fibrosis evaluation without additional ***,in general,these tests show low accuracy in discriminating between intermediate stages of fibrosis and may be influenced by several hepatic and extrahepatic *** methods are either serum markers(usually combined in a mathematical model)or imaging modalities that can be used separately or combined in algorithms to improve *** this review we will discuss the different noninvasive methods that are currently available for the evaluation of liver fibrosis in chronic hepatitis C,their advantages,limitations and application in clinical practice.

关键词： Liver fibrosis Liver cirrhosis Hepatitis C Diagnosis Elasticity imaging techniques

Central nervous system vasculitis and polyneuropathy as first manifestations of hepatitis C

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World Journal of Gastroenterology 2012年第2期18卷 188-191页

作者： Roberto J Carvalho-Filho janaína luz narciso-schiavon Luciano HL Tolentino Leonardo L schiavon Maria Lucia G Ferraz Antonio Eduardo B Silva Division of Gastroenterology Hepatitis SectionFederal University of Sao Paulo04037-003 Sao PauloBrazil

Sensory or motor peripheral neuropathy may be observed in a significant proportion of hepatitis C virus (HCV)-infected ***,central nervous system (CNS) involvement is uncommon,especially in cryoglobulin-negative *** describe a case of peripheral neuropathy combined with an ischemic CNS event as primary manifestations of chronic HCV infection without *** improvement was observed after antiviral *** discuss the spectrum of neurological manifestations of HCV infection and review the literature.

关键词： Hepatitis C Central nervous system Poly-neuropathy Interferon-α

Circulating insulin-like growth factor-binding protein 3 as prognostic biomarker in liver cirrhosis

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World Journal of Hepatology 2016年第17期8卷 739-748页

作者： Carina Gabriela Correa Bruno da Silveira Colombo Marcelo Fernando Ronsoni Pedro Eduardo Soares e Silva Leonardo Fayad Telma Erotides Silva Letícia Muraro Wildner Maria Luiza Bazzo Esther Buzaglo Dantas-Correa janaína luz narciso-schiavon Leonardo de Lucca schiavon Division of Gastroenterology Federal University of Santa Catarina Department of Clinical Analysis Federal University of Santa Catarina

AIM: To investigate the prognostic significance of insulin-like growth factor-binding protein 3(IGFBP-3) in patients with ***: Prospective study that included two cohorts: outpatients with stable cirrhosis(n = 138) and patients hospitalized for acute decompensation(n = 189). Development of complications, mortality or liver transplantation was assessed by periodical phone calls and during outpatient visits. The cohort of stable cirrhosis also underwent clinical and laboratory evaluation yearly(2013 and 2014) in predefined study visits. In patients with stable cirrhosis, IGFBP-3 levels were measured at baseline(2012) and at second re-evaluation(2014). In hospitalized subjects, IGFBP-3 levels were measured in serum samples collected in the first and in the third day after admission and stored at-80 ℃. IGFBP-3 levels were measured by ***: IGFBP-3 levels were lower in hospitalized patients as compared to outpatients(0.94 mcg/mL vs 1.69 mcg/m L, P nalysis showed that death or transplant was associated with lower IGFBP-3 levels(1.44 mcg/mL vs 1.74 mcg/m L, P = 0.027). The Kaplan-Meier transplant-free survival probability was 88.6% in patients with IGFBP-3 ≥ 1.67 mcg/mL and 72.1% for those with IGFBP3 < 1.67 mcg/mL(P = 0.015). In the hospitalized cohort, 30-d mortality was 24.3% and was independently associated with creatinine, INR, SpO_2/FiO_2 ratio and IGFBP-3 levels in the logistic regression. The 90-d transplant-free survival probability was 80.4% in patients with IGFBP-3 ≥ 0.86 mcg/mL and 56.1% for those with IGFBP3 < 0.86 mcg/mL(P < 0.001). CONCLUSION: Lower IGFBP-3 levels were associated with worse outcomes in patients with cirrhosis, and might represent a promising prognostic tool that can be incorporated in clinical practice.

关键词： Liver cirrhosis Acute decompensation Insulin-like growth factor binding protein 3 Acute-onchronic liver failure Prognosis

Celiac disease screening in patients with cryptogenic cirrhosis

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World Journal of Gastroenterology 2023年第2期29卷 410-412页

作者： janaina luz narciso-schiavon Leonardo Lucca schiavon Gastroenterology Division Internal Medicine DepartmentFederal University of Santa CatarinaFlorianopolis 88040-900SCBrazil

We write a letter to the editor commenting the article“Who to screen and how to screen for celiac disease”.We discuss the present literature on cirrhosis and celiac disease(CD)and recommend screening and treating CD... 详细信息

关键词： Celiac disease Liver cirrhosis Liver failure Aspartate aminotransferase Alanine aminotransferase

Fatty liver and celiac disease:Why worry?

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World Journal of Hepatology 2023年第5期15卷 666-674页

作者： janaina luz narciso-schiavon Leonardo Lucca schiavon Department of Internal Medicine Gastroenterology DivisionFederal University of Santa CatarinaFlorianópolis 88040-900Santa CatarinaBrazil

Celiac disease(CD)is a chronic inflammatory intestinal disorder mediated by the ingestion of gluten in genetically susceptible *** involvement in CD has been widely described,and active screening for CD is recommended in patients with liver diseases,particularly in those with autoimmune disorders,fatty liver in the absence of metabolic syndrome,noncirrhotic intrahepatic portal hypertension,cryptogenic cirrhosis,and in the context of liver ***-alcoholic fatty liver disease is estimated to affect approximately 25%of the world’s adult population and is the world’s leading cause of chronic liver *** view of both diseases’global significance,and to their correlation,this study reviews the available literature on fatty liver and CD and verifies particularities of the clinical setting.

关键词： liver involvement diseases

Elevated calprotectin levels are associated with mortality in patients with acute decompensation of liver cirrhosis

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World Journal of Hepatology 2022年第11期14卷 1964-1976页

作者： Camila Matiollo Elayne Cristina de Morais Rateke Emerita Quintina de Andrade Moura Michelle Andrigueti Fernanda Cristina de Augustinho Tamara Liana Zocche Telma Erotides Silva Lenyta Oliveira Gomes Mareni Rocha Farias janaina luz narciso-schiavon Leonardo Lucca schiavon Clinical Analysis Laboratory Unit University HospitalFederal University of Santa CatarinaFlorianopolis 88040-900Brazil Division of Gastroenterology University HospitalFederal University of Santa CatarinaFlorianópolis 88040-900Brazil Department of Pharmaceutical Sciences Health Sciences Center Federal University of Santa CatarinaFlorianópolis 88040-370Brazil Division of Gastroenterology Department of Internal MedicineFederal University of Santa CatarinaFlorianopolis 88040-900SCBrazil

BACKGROUND Acute decompensation(AD)of cirrhosis is related to systemic inflammation and elevated circulating *** this context,biomarkers of inflammation,such as calprotectin,may be of prognostic *** To evaluate serum calprotectin levels in patients hospitalized for complications of *** This is a prospective cohort study that included 200 subjects hospitalized for complications of cirrhosis,20 outpatients with stable cirrhosis,and 20 healthy *** calprotectin was measured by enzyme-linked immunosorbant *** Calprotectin levels were higher among groups with cirrhosis when compared to healthy *** median calprotectin was related to Child-Pugh C,ascites,and hepatic *** calprotectin was related to acute-on-chronic liver failure(ACLF)and infection in the bivariate,but not in multivariate *** was not associated with survival among patients with ACLF;however,in patients with AD without ACLF,higher calprotectin was associated with a lower 30-d survival,even after adjustment for chronic liver failure-consortium(CLIF-C)AD score.A high-risk group(CLIF-C AD score≥60 and calprotectin≥580 ng/mL)was identified,which had a 30-d survival(27.3%)similar to that of patients with grade 3 ACLF(23.3%).CONCLUSION Serum calprotectin is associated with prognosis in patients with AD without ACLF and may be useful in clinical practice to early identify patients with a very low short-term survival.

关键词： Inflammation Liver cirrhosis Acute-on-chronic liver failure

Sharp Heat Kernel Estimates in the Fourier–Bessel Setting for a Continuous Range of the Type Parameter

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Acta Mathematica Sinica,English Series 2014年第3期30卷 437-444页

作者： Adam NOWAK luz RONCAL Instytut Matematyczny Polska Akademia Nauk Departamento de Matemáticas y Computación Universidad de La Rioja

The heat kernel in the setting of classical Fourier-Bessel expansions is defined by an os- cillatory series which cannot be computed explicitly. We prove qualitatively sharp estimates of this kernel. Our method relies on establishing a connection with a situation of expansions based on Jacobi polynomials and then transferring known sharp bounds for the related Jacobi heat kernel.

关键词： Fourier-Bessel expansions heat kernel Bessel process transition density

Gastric cancer research in Mexico:A public health priority

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World Journal of Gastroenterology 2014年第16期20卷 4491-4502页

作者： Clara luz Sampieri Mauricio Mora Instituto de Salud Pública Universidad VeracruzanaAv. Luis Castelazo AyalaCol. Industrial ánimas91190 XalapaVeracruzMéxico Facultad de Medicina Universidad Veracruzana.Médicos y OdontólogosCol. Virginia Cordero91120 XalapaVeracruzMéxico

This study aimed review studies conducted on Mexican patients diagnosed with gastric cancer and/or diseases associated with its development,in which at least one Mexican institute has participated,and to assess their contributions to the primary and secondary prevention of this disease.A search of the Medline database was conducted using the following keywords:gastric/stomach cancer,*** of the Mexican population were selected in which at least one Mexican Institute had participated and where the findings could support public policy proposals directed towards the primary or secondary prevention of gastric *** the148 studies found in the Medline database,100 were discarded and 48 were *** to the analysis presented,these studies were classified as:epidemiology of gastric cancer(5/48);risk factors and protectors relating to gastric cancer(9/48);relationship between Helicobacter pylori and pathologies associated with gastric cancer and the development of the disease(16/48);relationship between the Epstein-Barr virus and pathologies associated with gastric cancer and the development of the disease(3/48);molecular markers for the development of diseases associated with gastric cancer and gastric cancer(15/48).Mexico requires a program for the prevention and control of gastric cancer based on national health *** should be produced by a multidisciplinary committee of experts who can propose actions that are relevant in the current national *** few studies of gastric cancer conducted on the Mexican population in national institutes highlight the poor connection that currently exists between the scientific community and the health sector in terms of resolving this health *** policies for health research should support projects with findings that can be translated into benefits for the *** review serves to identify national research groups studying gastric cancer in the Mexican population.

关键词： Gastric cancer Mexico Research Prevention Public health