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Use of endoscopic ultrasound for diagnosis of cholangiocarcinoma in auto-immune hepatitis

World Journal of Gastrointestinal Endoscopy 2010年第12期2卷 404-407页

作者： Nathaniel S Rial Jeff T Henderson Achyut K Bhattacharyya Abdul Nadir John T Cunningham Department of Internal Medicine College of Medicine Arizona Cancer Center and Mel & Enid College of Public Health The University of Arizona Tucson Arizona Digestive Health Pathology Laboratory Director Surgical Pathology Professor and Head Department of Pathology College of Medicine The University of Arizona Tucson Department of Gastroenterology College of Medicine The University of Arizona Tucson

In this report, a patient was exposed to an herbal remedy for hypercholesterolemia. She became acutely jaundiced while taking the remedy and presented for medical care. Endoscopic ultrasound was utilized, and found a distal common bile duct mass. Endoscopic retrograde cholangiopancreatography guided bile duct biopsies revealed that the mass was cholangio-carcinoma (CCA). This case highlights a unique association between autoimmune hepatitis and CCA. It also highlights that EUS can be safely used in patients with cirrhosis to spare invasive evaluation such as exploratory laporotomy for diagnosis and staging of cholangio-carcinoma.

关键词： Cholangiocarcinoma Endoscopic ultrasound Auto-immune hepatits

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Enterogenous bacterial glycolipids are required for the generation of NKT cell-mediated liver injury

Enterogenous bacterial glycolipids are required for the gene...

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浙江省免疫学会第十次学术大会

作者： Yingfeng Wei Benhua Zeng Jianing Chen Jianqin He Guangying Cui Chong Lu Wei Wu Jiezuan Yang Zhi Chen Lanjuan Li Rufeng Xue Li Bai Hong Wei Kazuya Iwabuchi Toshimitsu Uede Luc Van Kaer Hongyan Diao State Key Laboratory for Diagnosis and Treatment of Infectious Diseases Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalSchool of MedicineZhejiang University Department of Laboratory Animal Science College of Basic Medical SciencesThird Military Medical University Institute of Immunology and Key Laboratory of Innate Immunity and Chronic Disease of CAS School of Life Sciences andMedical CenterUniversity of Science and Technology of China Innovation Center for Cell Biology Hefei National Laboratory for Physical Sciences at Microscale Department of Immunology Kitasato University School of Medicine Molecular Immunology Institute for Genetic MedicineHokkaido University Department of Microbiology and Immunology Vanderbilt University School of Medicine

Background:Glycolipids are potent activator of CD1 d-restricted natural killer T(NKT) cells,they activate NKT cells mainly through the antigen presentation by CD1 *** cells has a pivotal role in the induction of liver injury by the lectin concanavalin A(ConA).Intestinal microflora can affect the progression of liver disease;however,the relationship between intestinal bacteria-derived glycolipids and liver injury remains *** therefore investigated the role of gut bacteria-derived glycolipids in regulating NKT cell-mediated liver ***:In sharp contrast to specific pathogen-free(SPF) mice,germ-free(GF) mice are resistant to ConA-induced liver *** showed that ConA treatment failed to trigger the activation of hepatic NKT cells in GF *** defects correlated with sharply reduced levels of CD1 d-presented glycolipid antigens and serum lipopolysaccharide(LPS) in ConA-treated GF mice compared with SPF ***,CD1 d expression was similar between GF and SPF ***,the absence of intestinal bacteria failed to affect the incidence of aGalCer-induced liver injury in GF *** further established that hepatic NKT and relevant APCs in SPF and GF mice have similar ***,treatment of GF mice with killed intestinal bacteria prior was able to restore ConA-mediated activation of hepatic NKT cells and its subsequent liver ***:These findings indicate that enterogenous bacterial glycolipids are important hepatic NKT cell agonist and these enterogenous bacterial antigens are required for ConA-induced liver injury.

关键词： natural killer T cell germ-free mice glycolipids hepatits

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