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Liver Fat Scores for Noninvasive Diagnosis and Monitoring of Nonalcoholic Fatty Liver Disease in Epidemiological and Clinical Studies

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Journal of Clinical and Translational Hepatology 2023年第5期11卷 1212-1227页

作者： Mona reinshagen Stefan k.bisch Andreas F.H.Pfeiffer Joachim Spranger Department of Endocrinology and Metabolism Campus Benjamin FranklinCharitéUniversity MedicineBerlinGermany Deutsches Zentrum für Diabetesforschung e.V. Geschäftsstelle am Helmholtz-Zentrum MünchenNeuherbergGermany

Nonalcoholic fatty liver disease(NAFLD)is strongly associated with the metabolic syndrome and type 2 diabetes and independently contributes to long-term *** often asymptomatic but reversible,it would require population-wide screening,but direct diagnostics are either too invasive(liver biopsy),costly(MRI)or depending on the examiner’s expertise(ultrasonography).Hepatosteatosis is usually accommodated by features of the metabolic syndrome(***,disturbances in triglyceride and glucose metabolism),and signs of hepatocellular damage,all of which are reflected by biomark.rs,which poorly predict NAFLD as single item,but provide a cheap diagnostic alternative when integrated into composite liver fat *** liver index,NAFLD LFS,and hepatic steatosis index are common and accurate indices for NAFLD prediction,but show limited accuracy for liver fat *** indices are rarely *** fibrosis scores are commonly used in clinical practice,but their mandatory reflection of fibrotic reorganization,hepatic injury or systemic sequelae reduces sensitivity for the diagnosis of simple ***-induced liver fat changes are poorly reflected by liver fat indices,depending on the intervention and its specific impact of weight loss on *** limited validity in longitudinal settings stimulates research for new ***,hepatok.nes,mark.rs of cellular integrity,genetic variants but also simple and inexpensive routine parameters might be potential ***,liver fat indices lack.precision for NAFLD prediction or monitoring in individual patients,but in large cohorts they may substitute nonexistent imaging data and serve as a compound biomark.r of metabolic syndrome and its cardiometabolic sequelae.

关键词： NAFLD Liver fat indices Fatty liver index Prediction Dietary intervention

Bones and Crohn’s:No benefit of adding sodium fluoride or ibandronate to calcium and vitamin D

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World Journal of Gastroenterology 2011年第3期17卷 334-342页

作者： Jochen k.aus Max reinshagen k.tharina Herdt Christoph Schrter Guido Adler Georg BT von Boyen Christian von Tirpitz Department of Internal Medicine I University of Ulm Albert Einstein Allee 23 89081 Ulm Germany Department of Internal Medicine I Stdtisches Klinikum Braunschweig Salzdahlumer Straβe 90 38126 Braunschweig Germany Medizinische k.inik Kreisklinik Biberach Ziegelhausstraβe 50 88400 Biberach Germany

AIM: To compare the effect of calcium and cholecalciferol alone and along with additional sodium fluoride or ibandronate on bone mineral density (BMD) and fractures in patients with Crohn's disease (CD). METHODS: Patients (n =148) with reduced BMD (T-score < -1) were randomized to receive cholecalciferol (1000 IU) and calcium citrate (800 mg) daily alone(group A, n = 32) or along with additional sodium fluoride (25 mg bid) (group B, n = 62) or additional ibandronate (1 mg iv/3-monthly) (group C, n = 54). Dual energy X-ray absorptiometry of the lumbar spine (L1-L4) and proximal right femur and X-rays of the spine were performed at baseline and after 1.0, 2.25 and 3.5 years. Fracture-assessment included visual reading of X-rays and quantitative morphometry of vertebral bodies (T4-L4).RESULTS: One hundred and twenty three (83.1%) patients completed the first year for intention-to-treat (ITT) analysis. Ninety two (62.2%) patients completed the second year and 71 (47.8%) the third year available for per-protocol (PP) analysis. With a significant increase in T-score of the lumbar spine by +0.28 ± 0.35 [95% conf idence interval (CI): 0.162-0.460, P < 0.01], +0.33 ± 0.49 (95% CI: 0.109-0.558, P < 0.01), +0.43 ± 0.47 (95% CI: 0.147-0.708, P < 0.01) in group A, +0.22 ± 0.33 (95% CI: 0.125-0.321, P < 0.01); +0.47 ± 0.60 (95% CI: 0.262-0.676, P < 0.01), +0.51 ± 0.44 (95% CI: 0.338-0.682, P < 0.01) in group B and +0.22 ± 0.38 (95% CI: 0.111-0.329, P < 0.01), +0.36 ± 0.53 (95% CI: 0.147-0.578, P < 0.01), +0.41 ± 0.48 (95% CI: 0.238-0.576, P < 0.01) in group C, respectively, during the 1.0, 2.25 and 3.5 year periods (PP analysis), no treatment regimen was superior in any in- or between-group analyses. In the ITT analysis, similar results in all in- and between-group analyses with a significant in-group but non-significant between-group increase in T-score of the lumbar spine by 0.38 ± 0.46 (group A, P < 0.01), 0.37 ± 0.50 (group B, P < 0.01) and 0.35 ± 0.49 (group C, P < 0.01) was

关键词： Crohn’s disease Bone mineral density Vertebral fracture Cholecalciferol Calcium Ibandronate Sodium fluoride

Open label trial of granulocyte apheresis suggests therapeutic efficacy in chronically active steroid refractory ulcerative colitis

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World Journal of Gastroenterology 2005年第44期11卷 7001-7006页

作者： Wolfgang k.uis Axel Dignass Elisabeth Steinhagen-Thiessen Julia Morgenstern Joachim M(o|¨)ssner Stephan Schreiber Maurizio Vecchi Alberto Malesci Max reinshagen Robert L(o|¨)fberg Evangelisches k.ank.nhaus k.lk Medizinische k.inik.für Hepatologie und Gastroenterologie Medizinische k.inik.und Polik.inik.Ⅱ Medizinische k.inik Dep of Int Medicine IRCCS Ospedale Policlinico Istituto Clinico Humanitas Innere Medizin k.rolinsk. Institute at the IBD unit

AIM： To study the efficacy, safety, and feasibility of a granulocyte adsorptive type apheresis system for the treatment of patients with chronically active ulcerative colitis despite standard therapy. METHODS： An open label multicenter study was carried out in 39 patients with active ulcerative colitis （CAI 6-8） despite continuous use of steroids （a minimum total dose of 400 mg prednisone within the last 4 wk.. Patients received a total of five aphereses using a granulocyte adsorptive technique （Adacolumn, Otsuk. Pharmaceutical Europe, Uk.. Assessments at wk.6 and during follow-up until 4 mo comprised clinical （CAI） and endoscopic （EI） activity index, histology, quality of life （IBDQ）, and laboratory tests. RESULTS： Thirty-five out of thirty-nine patients were qualified for intent-to-treat analysis. After the apheresis treatment at wk.6, 13/35 （37.1%） patients achieved clinical remission and 10/35 （28.6%） patients had endoscopic remission （CAI〈4, EI〈4）. Quality of life （IBDQ） increased significantly （24 points, P〈0.01） at wk.6. Apheresis could be performed in all but one patient. Aphereses were well tolerated, only one patient experienced anemia. CONCLUSION： In patients with steroid refractory ulcerative colitis, five aphereses with a granulocyte/ monocyte depleting filter show potential short-term efficacy. Tolerability and technical feasibility of the procedure are excellent.

关键词： Steroid Refractory colitis Ulcerative colitis Granulocyte Apheresis

炎症性肠病治疗策略：逐步升级抑或逐步降阶疗法？

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中华消化杂志 2008年第12期28卷 822-823页

作者： reinshagen M 胡品津(译) 陈白莉(译) 德国布伦瑞克医院中山大学医学院附属第一医院消化科 510080

关于炎症性肠病（IBD）的治疗，国际指南推荐对溃疡性结肠炎（UC）及克罗恩病（CD）患者使用逐步升级（bottom—up）的治疗方法。逐步升级疗法是根据患者病变范围及严重程度，治疗从采用5-氨基水杨酸制剂和（或）布地奈德、或肾上腺糖... 详细信息

关于炎症性肠病（IBD）的治疗，国际指南推荐对溃疡性结肠炎（UC）及克罗恩病（CD）患者使用逐步升级（bottom—up）的治疗方法。逐步升级疗法是根据患者病变范围及严重程度，治疗从采用5-氨基水杨酸制剂和（或）布地奈德、或肾上腺糖皮质激素（简称激素）开始，对激素依赖或激素抵抗的慢性-活动性患者下一步应用免疫抑制剂硫唑嘌呤治疗。对免疫抑制剂无效者，则予以生物学制剂肿瘤坏死因子（TNF）-α单克隆抗体（单抗）治疗。

关键词：治疗方法炎症性肠病升级疗法肾上腺糖皮质激素 5-氨基水杨酸制剂 (TNF)-α 免疫抑制剂溃疡性结肠炎

CXCR5^(+)PD-1^(++)CD4^(+)T cells colonize infant intestines early in life and promote B cell maturation

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Cellular & Molecular Immunology 2023年第2期20卷 201-213页

作者： Ana Jordan-Paiz Glòria Martrus Fenja L.Steinert Max k.ufmann Adrian F.Sagebiel Renée R.C.E.Schreurs Anne Rechtien Martin E.Baumdick.Johannes M.Jung k.mberly J.Möller Lucy Wegner Cordula Grüttner Laura Richert Roland Thünauer Jennifer Schroeder-Schwarz Johannes Bvan Goudoever Teunis B.H.Geijtenbeek.Marcus Altfeld Steven T.Pals Daniel Perez Paul L.k.arenbeek.Christian Tomuschat Guido Sauter Ingo k.nigs Udo Schumacher Manuel A.Friese Nathaniel Melling k.nrad reinshagen Madeleine J.Bunders Department of Virus Immunology Leibniz Institute of VirologyHamburg20251Germany University Medical Center Hamburg-Eppendorf Hamburg20246Germany Institute of Neuroimmunology and Multiple Sclerosis Center for Molecular Neurobiology HamburgUniversity Medical Center Hamburg-EppendorfHamburg20251Germany Department of General Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-EppendorfHamburg20246Germany Department of Experimental Immunology Amsterdam Infection&Immunity InstituteAmsterdam University Medical CenterUniversity of AmsterdamAmsterdam1105 AZThe Netherlands Department of Pediatrics Emma Children’s HospitalAmsterdam University Medical CenterUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdam1105 AZThe Netherlands I.Department of Medicine University Medical Center Hamburg-EppendorfHamburg20246Germany Partner Site Hamburg-Lübeck.Borstel-Riems German Center for Infection Research(DZIF)Hamburg20246Germany University of Bordeaux Institut National de la Santéet de la Recherche MédicaleBordeaux Population Health Research Center UMR1219 and INRIA SISTM TeamBordeaux33000France Institute of Anatomy and Experimental Morphology University Medical Center Hamburg-EppendorfHamburg20246Germany Department of Pathology Amsterdam University Medical CenterUniversity of AmsterdamAmsterdam1105 AZThe Netherlands Department of Rheumatology and Clinical Immunology and Department of Experimental Immunology Amsterdam Infection&Immunity InstituteAmsterdam University Medical CenterUniversity of AmsterdamAmsterdam1007 MBThe Netherlands Amsterdam Rheumatology&Immunology Center Amsterdam University Medical CenterUniversity of AmsterdamAmsterdam1105 AZThe Netherlands Department of Pediatric Surgery University Medical Center Hamburg-EppendorfHamburg20246Germany Institute of Pathology University Medical Center Hamburg-EppendorfHamburg20246Germany Department of Pediatric Surgery Altona Children’s HospitalHamburg22763Germany III.Department of Medicine University M

Gastrointestinal infections are a major cause for serious clinical complications in *** induction of antibody responses by B cells is critical for protective immunity against infections and requires CXCR5+PD-1++CD4+T cells(TFH cells).We investigated the ontogeny of CXCR5+PD-1++CD4+T cells in human *** CXCR5+PD-1++CD4+T cells were absent in fetal intestines,CXCR5+PD-1++CD4+T cells increased after birth and were abundant in infant intestines,resulting in significant higher numbers compared to *** findings were supported by scRNAseq analyses,showing increased frequencies of CD4+T cells with a TFH gene signature in infant intestines compared to ***-cultures of autologous infant intestinal CXCR5+PD-1+/−CD4+T cells with B cells further demonstrated that infant intestinal TFH cells were able to effectively promote class switching and antibody production by B *** together,we demonstrate that functional TFH cells are numerous in infant intestines,mak.ng them a promising target for oral pediatric vaccine strategies.

关键词： TFH cells B cells Antibodies Intestine Pediatrics