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Non-alcoholic fatty liver disease and COVID-19: Harmless companions or disease intensifier?

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World Journal of Gastroenterology 2023年第2期29卷 367-377页

作者： Christoph G Dietrich andreas geier Uta Merle Gastro-Praxis Wiesbaden Leberzentrum WiesbadenWiesbaden 65189Germany Division of Hepatology Department of Medicine IIUniversity Hospital WuerzburgWuerzburg 97080Germany Department of Gastroenterology and Hepatology University Hospital HeidelbergHeidelberg 69120Germany

The pandemics of coronavirus disease 2019(COVID-19)and non-alcoholic fatty liver disease(NAFLD)*** liver function tests are frequent in COVID-19 and may influence liver damage in NAFLD,while preexisting liver damage from NAFLD may influence the course of ***,the prognostic relevance of this interaction,though,is *** is a risk factor for the presence of NAFLD as well as a severe course of *** studies reveal conflicting results regarding the influence of NAFLD presence on COVID-19 illness *** molecular similarities of cytokine pathways in both diseases,including postacute sequelae of COVID-19,suggest common pathways for chronic low-activity *** review will summarize existing data regarding the interaction of both diseases and discuss possible mechanisms of the influence of one disease on the other.

关键词： COVID-19 Postacute sequelae of COVID-19 Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Inflammation Fatty liver

Molecular changes in hepatic metabolism and transport incirrhosis and their functional importance

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World Journal of Gastroenterology 2016年第1期22卷 72-88页

作者： Christoph G Dietrich Oliver Götze andreas geier Bethlehem Center of Health Department of Internal MedicineD-52222 Stolberg(Rhineland)Germany University of Würzburg Division of HepatologyDepartment of Internal Medicine IID-97080 WürzburgGermany

Liver cirrhosis is the common endpoint of many hepatic diseases and represents a relevant risk for liver failure and hepatocellular *** progress of liver fibrosis and cirrhosis is accompanied by deteriorating liver *** review summarizes the regulatory and functional changes in phase Ⅰ and phaseⅡmetabolic enzymes as well as transport proteins and provides an overview regarding lipid and glucose metabolism in cirrhotic ***,phase Ⅰ enzymes are generally down regulated transcriptionally,while phaseⅡenzymes are mostly preserved transcriptionally but are reduced in their *** proteins are regulated in a specific way that resembles the molecular changes observed in obstructive *** and glucose metabolism are characterized by insulin resistance and catabolism,leading to the disturbance of energy expenditure and *** non-invasive tests,especially breath tests,for components of liver metabolism are *** heterogeneity and complexity of changes in hepatic metabolism complicate the assessment of liver function in individual ***,studies in humans are rare,and species differences preclude the transferability of data from rodents to *** clinical practice,some established global scores or criteria form the basis for the functional evaluation of patients with liver cirrhosis,but difficult treatment decisions such as selection for transplantation or resection require further research regarding the application of existing non-invasive tests and the development of more specific tests.

关键词： liver cirrhosis drug metabolism transport breath tests lipid metabolism glucose metabolism

Origin of and therapeutic approach to cardiac syndrome X:Results of the proton pump inhibitor therapy for angina-like lingering pain trial (PITFALL trial)

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World Journal of Gastroenterology 2008年第42期14卷 6506-6512页

作者： Christoph G Dietrich Susanne Laupichler Sven Stanzel Ron Winograd Oliver Al-Taie Carsten Gartung andreas geier Department of Gastroenterology Aachen University Aachen 52074 Germany Department of Gastroenterology Klinikum Aschaffenburg Aschaffenburg 63739 Germany Department of Medical Statistics AachenUniversity Aachen 52074 Germany Department of Gastroenterology University Hospital Zurich Zurich 8091 Switzerland

AIM: To investigate the frequency of gastroen-terological diseases in the etiology and the efficacy of proton pump inhibitors (PPIs) in the treatment of cardiac syndrome X (CSX) as a subform of non-cardiac chest pain (NCCP). METHODS: We investigated 114 patients with CSX using symptom questionnaires. A subgroup of these patients were investigated regarding upper gastrointestinal disorders (GIs) and treated with PPI. Patients not willing to participate in investigation and treatment served as control group. RESULTS: Thirty-six patients denied any residual symptoms and were not further evaluated. After informed consent in 27 of the remaining 78 patients, we determined the prevalence of disorders of the upper GI tract and quantifi ed the effect of treatment with pantoprazole. We found a high prevalence of gastroenterological pathologies (26/27 patients, 97%)with gastritis, gastroesophageal reflux disease (GERD) and acid reflux as the most common associated disorders. If treated according to the study protocol, these patients showed a significant improvement in the symptom score. Patients treated by primary care physicians, not according to the study protocol had a minor response to treatment (n = 19, -43%), while patients not treated at all (n = 26) had no improvement of symptoms (-0%). CONCLUSION: Disorders of the upper GI tract are a frequent origin of CSX in a German population and can be treated with pantoprazole if given for a longer period.

关键词： Non-cardiac chest pain Gastroesophageal reflux disease Proton pump inhibitor Cardiac syndrome X

Side effects of budesonide in liver cirrhosis due to chronic autoimmune hepatitis: Influence of hepatic metabolism versus portosystemic shunts on a patient complicated with HCC

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World Journal of Gastroenterology 2003年第12期9卷 2681-2685页

作者： andreas geier Carsten Gartung Christoph G.Dietrich Hermann E.Wasmuth Patrick Reinartz Siegfried Matern Department of Intemal Medicine Ⅲ University of Technology (RWTH) AachenAachenGermany Nuclear Medicine University of Technology (RWTH) AachenAachenGermany Department of Internal Medicine Ⅲ University of Technology (RWTH) AachenAachenGermany

AIM:To investigate the systemic availability of budesonide in a patient with Child A cirrhosis due to autoimmune hepatitis (AIH) and primary hepatocellular carcinoma,who developed serious side effects. METHODS:Serum levels of budesonide,6β-OH-budesonide and 16α-OH-prednisolon were measured by HPLC/MS/MS; portosystemic shunt-index (SI) was determined by 99mTc nuclear *** values were compared with a matched control patient without side effects. RESULTS:Serum levels of budesonide were 13-fold increased in the index *** ratio between serum levels of the metabolites 6β-OH-budesonide and 16α-OH- prednisolone,respectively,and serum levels of budesonide was diminished (1.0 vs.4.0 for 6β-OH-budesonide,4.2 vs. 10.7 for 16α-OH-prednisolone).Both patients had portosystemic SI (5.7 % and 3.1%) within the range of healthy ***:Serum levels of budesonide Vary uP to 13-fold in AIH Patients with Child A eirrhosis in the absenee ofrelevant Portosystemic *** hePatiemetabolism,as indicated by redueed metabolite-to-drugratio,rather than Portosystemie shunting may explainsystemic side effects of this drug in cirrhosis

关键词： Portasystemic Shunt, Surgical Aged Anti-Inflammatory Agents Budesonide Carcinoma, Hepatocellular Female Hepatitis, Autoimmune Humans Liver Liver Neoplasms Research Support, Non-U.S. Gov't

Occult celiac disease prevents penetrance of hemochromatosis

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World Journal of Gastroenterology 2005年第21期11卷 3323-3326页

作者： andreas geier Carsten Gartung Igor Theurl Guenter Weiss Frank Lammert Christoph G.Dietrich Ralf Weiskirchen Heinz Zoller Benita Hermanns Siegfried Matern Department of Internal Medicine Ⅲ Aachen University (RWTH) AachenGermany Department of Internal Medicine University of Innsbruck InnsbruckAustria Department of Clinical Chemistry and Pathobiochemistry Aachen University(RWTH) AachenGermany Department of Pathology Aachen University (RWTH) AachenGermany Department of Internal Medicine Ⅲ Aachen University(RWTH) Aachen Germany

AIM:To report a patient with C282Y homozygocity,depleted body iron and intestinal atrophy caused by celiac disease (CD) who experienced resolution of the enteropathy with subsequent normalization of iron metabolism upon gluten free diet. METHODS:To obtain information on the tissue distribution and quantitative expression of proteins involved in duodenal iron trafficking,we determined the expression of divalent-metal transporter 1 (DMT1),ferroportin 1 (FP1) and transferrin receptor (TfR1) by means of immunohist-ochemistry and real-time PCR in duodenal biopsies of this patient. RESULTS:Whereas in hereditary hemochromatosis patients without CD, DMT1 expression was up-regulated leading to excessive uptake of iron, we identified a significant reduction in protein ana mRNA expression of DMT1 as a compensatory mechanism in this patient with HH and CD. CONCLUSION:Occult CD may compensate for increased DMT1 expression in a specific subset of individuals with homozygous C282Y mutations in the hemochromatosis (HFE) gene,thus contributing to the low penetrance of HH.

关键词： Hemochromatosis Celiac disease Divalentmetal transporter 1 Transferrin receptor Iron metabolism