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The transcontinental variability of nonalcoholic fatty liver disease

Hepatoma Research 2020年第10期6卷 75-87页

作者： Claudia P.Oliveira Angelo Paredes Mohammed Siddiqui Lawrence Serfaty Abhijit Chowdhury Jose Tadeu Stefano Denise Siqueira Vanni Sherry Boyett Arun J.Sanyal Department of Gastroenterology Faculdade de Medicina da Universidade de São PauloSão PauloSP 01000-000Brazil Laboratório de gastroenterologia Clínica e experimental(LIM-07)do Departamento de gastroenterologia e Hepatologia do Hospital das Clínicas HCFMUSP da Faculdade de Medicina da Universidade de São Paulo São PauloSP 01000-000Brazil Internal Medicine Gastroenterology and Hepatology ServicesBrooke Army Medical CenterSan AntonioTX 78234USA Div.of Gastroenterology Hepatology and NutritionDept.of Internal MedicineVirginia Commonwealth University School of MedicineRichmondVA 23298-0341USA Viral and Metabolic Liver Unit Department of HepatologySaint-Antoine Hospital75012 ParisParis Department of Hepatology School of Digestive and Liver DiseaseInstitute of Post Graduate Medical Education&ResearchKolkata 700020India Disease Biology John C Martin Centre for Liver Research and Innovations SonarpurKolkata 7000150India

Aim:To compare the phenotype of lean versus overweight(OW)and obese(OB)subjects with non-alcoholic fatty liver disease(NAFLD)across multiple continents.Methods:A retrospective study of histologically defined subjects from a single center each in France(Fr),Brazil(Br),India(In)and United States(US)was performed.Results:A total of 70 lean[body mass index(BMI)ects(Fr:Br:In:US:16:19:22:13)with NAFLD were compared to 136 OW(BMI>25 kg/m2,BMIects(BMI>29 kg/m2)(n=81:11:22:103).Lean French subjects had the lowest incidence of type 2 diabetes while those from Brazil(Pe highest.Lean subjects had similar low-density lipoprotein-cholesterol,but higher high-density lipoprotein-cholesterol compared to obese subjects in all regions.In both lean and obese subjects,there were both insulin-sensitive and insulin-resistant subjects.Lean French subjects were most insulin-sensitive while those from Brazil were mostly insulin-resistant.For each weight category,subjects from India were more insulin-sensitive than those from other regions.Disease activity increased from lean to overweight to obese in France but was similar across weight categories in other regions.Conclusion:The phenotype of NAFLD in lean subjects varies by region.Some obese subjects with NAFLD are insulin-sensitive.We hypothesize that genetics and region-specific disease modifiers account for these differences.

关键词： Non-alcoholic fatty liver disease phenotype epidemiology demographics

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Antioxidant properties of glutamine and its role in VeGF-Akt pathways in portal hypertension gastropathy

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World Journal of Gastroenterology 2013年第28期19卷 4464-4474页

作者： Camila Marques Francielli Licks Ingrid Zattoni Beatriz Borges Luiz eduardo Rizzo de Souza Claudio Augusto Marroni Norma Possa Marroni Universidade Federal do Rio Grande do Sul-PPG Fisiologia Porto Alegre 90000100 Brazil Universidade Federal do Paraná Curitiba 81531900 Brazil Departamento de Medicina Interna-Gastroenterologia-Universidade Federal de Ciências da Saúde de Porto Alegre Porto Alegre 90000100 Brazil Universidade Federal do Rio Grande do Sul-PPG Fisiologia Universidade Luterana do Brasil Porto Alegre 90000100 Brazil

AIM: To investigate the effects of glutamine on oxidative/nitrosative stress and the vascular endothelial growth factor (VeGF)-Akt-endothelial nitric oxide synthase (eNOS) signaling pathway in an experimental model of portal hypertension induced by partial portal vein ligation (PPVL). MeTHODS: Portal hypertension was induced by PPVL. The PPVL model consists of a partial obstruction of the portal vein, performed using a 20 G blunt needle as a guide, which is gently removed after the procedure. PPVL model was performed for 14 d beginning treatment with glutamine on the seventh day. On the fifteenth day, the mesenteric vein pressure was checked and the stomach was removed to test immunoreactivity and oxidative stress markers. We evaluated the expression and the immunoreactivity of proteins involved in the VeGF-Akt-eNOS pathway by Western blotting and immunohistochemical analysis. Oxidative stress was measured by quantification of the cytosolic concentration of thiobarbituric acid reactive substances (TBARS) as well as the levels of total glutathione (GSH), superoxide dismutase (SOD) activity, nitric oxide (NO) production and nitrotyrosine immunoreactivity. ReSULTS: All data are presented as the mean ± Se. The production of TBARS and NO was significantly increased in PPVL animals. A reduction of SOD activity was detected in PPVL + G group. In the immunohistochemical analyses of nitrotyrosine, Akt and eNOS, the PPVL group exhibited significant increases, whereas decreases were observed in the PPVL + G group, but no difference in VeGF was detected between these groups. Western blotting analysis detected increased expression of phosphatidylinositol-3-kinase (PI3K), P-Akt and eNOS in the PPVL group compared with the PPVL + G group, which was not observed for the expression of VeGF when comparing these groups. Glutamine administration markedly alleviated oxidative/nitrosative stress, normalized SOD activity, increased levels of total GSH and blocked NO overproduction as well as the formation of peroxynitrite. CONCLUSION:

关键词： Partial portal vein ligation Oxidative stress Glutamine Portal hypertension Rats

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Microscopic enteritis:Bucharest consensus

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World Journal of Gastroenterology 2015年第9期21卷 2593-2604页

作者： Kamran Rostami David Aldulaimi Geoffrey Holmes Matt W Johnson Marie Robert Amitabh Srivastava Jean-Francois Fléjou David S Sanders Umberto Volta Mohammad H Derakhshan James J Going Gabriel Becheanu Carlo Catassi Mihai Danciu Luke Materacki Kamran Ghafarzadegan Sauid Ishaq Mohammad Rostami-Nejad A Salvador Pe?a Gabrio Bassotti Michael N Marsh Vincenzo Villanacci Department of Gastroenterology Alexandra HospitalWorcestershire B98 7UBUnited Kingdom Department of Gastroenterology Royal Derby HospitalDerby DE22 3NEUnited Kingdom Gastroenterology Unit Luton Dunstable University FT Hospital LU4 0DZUnited Kingdom Department of Pathology and Medicine Yale University School of MedicineNew HavenCT 06520United States Department of Pathology Staff PathologistBrigham and Women’s HospitalHarvard Medical School BostonBostonMA 02115United Sates Department of Pathology Serviced’Anatomie PathologiqueHopital Saint-AntoineAP-HPUniversité Pierre et Marie Curie75005 ParisFrance Department of Gastroenterology University of SheffieldSouth Yorkshire S10 2TNUnited Kingdom Department of Gastroenterology Department of Medical and Surgical SciencesUniversity of Bologna40126 BolognaItaly Section of Gastroenterology Institute of Cardiovascular and Medical SciencesUniversity of GlasgowGlasgow G12 8QQUnited Kingdom Department of Pathology Southern General HospitalLanarkshire G51 4TFUnited Kindom Department of Pathology Carol Davila Univerity of Medicine and PharmacyBucharest 050474Romania Università Politecnica delle Marche AnconaItalyPresidente Società Italiana di GastroenterologiaEpatologia e Nutrizione PediatricaCo-DirectorCenter For Celiac Research University of Maryland School of Medicine BaltimoreMD 21201United States Grigore T Popa" University of Medicine and Pharmacy Iasi 747800Romania Laboratory Department Mashad Razavi HospitalKhorasan Razavi ***Iran Dudley group of Hospitals Birmingham City UniversityBirmingham B42 2SUUnited Kindom Gastroenterology and Liver Diseases Research Institute Shahid Beheshti University of Medical SciencesTehran ***Iran Laboratory of Immunogenetics Department of Medical Microbiology and Infection ControlVrije Universiteit medical centre (VUmc)1081 HZ AmsterdamThe Netherlands Gastroenterology Section Department of MedicineUniversity of Perugia Medical School06100 PerugiaItaly Wolfson College University of OxfordOxford

Microscopic enteritis(Me) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms,nutrient and micronutrient deficiency.It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy.This work recognises a need to characterize disorders with microscopic and submicroscopic features,currently regarded as functional or non-specific entities,to obtain further understanding of their clinical relevance.The consensus working party reviewed statements about the aetiology,diagnosis and symptoms associated with Me and proposes an algorithm for its investigation and treatment.Following the 5th International Course in Digestive Pathology in Bucharest in November 2012,an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on Me.A five-step agreement scale(from strong agreement to strong disagreement) was used to score 21 statements,independently.There was strong agreement on all statements about Me histology(95%-100%).Statements concerning diagnosis achieved 85% to 100% agreement.A statement on the management of Me elicited agreement from the lowest rate(60%) up to 100%.The remaining two categories showed general agreement between experts on clinical presentation(75%-95%) and pathogenesis(80%-90%) of Me.There was strong agreement on the histological definition of Me.Weaker agreement on management indicates a need for further investigations,better definitions and clinical trials to produce quality guidelines for management.This Me consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.

关键词： Microscopic enteritis enteropathy Gluten Malabsorption Non-celiac gluten Bucharest consensus

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便秘合并功能性消化不良患者的症状与病理生理学功能的相关性

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 16-16页

作者： Sarnelli G. Grasso R. Ierardi e. R. Cuomo 徐瑞 gastroenterologia Dipartimento di Medicina Clinica e Sperimentale Universit degli Studi di Napoli‘Federico II’Via Sergio Pansini 5 IT-80131 Naples Italy Dr.

Introduction: Patients with constipation often report dyspeptic symptoms, but whether constipation is associated with specific dyspeptic symptoms and altered gastrointestinal (GI) motility, remains to be established. Our aim was to study symptoms association and GI motility parameters in patients with constipation and functional dyspepsia. Patients and Method: 42 patients with different symptoms and severity of constipation and dyspepsia were enrolled. Scintigraphic gastric emptying, colonic transit time and gallbladder contraction were studied in all subjects. Results: No significant association was observed between individual symptoms of constipation and dyspepsia. Patients with more severe constipation did not have higher dyspepsia severity scores. Colonic transit time, gastric half emptying and gallbladder contraction were not significantly correlated. Although patients with severe nausea had faster colonic transit than those with absent/mild symptom (19 ± 2 vs. 48 ± 7 h; p e multivariate analysis only revealed a significant association between severe postprandial fullness, delayed t 1/2 (OR1.05, CI 1- 1.1) and impaired gallbladder contraction (OR 0.94, CI 0.89- 0.99). Conclusions: Constipation was not associated with severity, or any particular dyspeptic symptom. Although motor abnormalities of both colon and proximal GI tract regions existed in the subset of constipated dyspeptic patients, they did not seem associated with the genesis of different dyspeptic symptoms.

关键词：病理生理学胆囊收缩闪烁扫描传送时间运动异常便秘患者胃排空近端特异性多因素分析

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小肠肠系膜超声造影成像评分系统:一项很有前景的乳糜泻诊断与随访方法

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 45-45页

作者： Dell’Aquila P. Pietrini L. Barone M. e. Ierardi 郑世成 Cattedra di gastroenterologia Università di Foggia c/o Ospedali Riuniti Viale L. Pinto 71 100 Foggia Italy Dr.

Background: Small intestinal ultrasonography with anechoic contrast agents (SICUS) has been shown to have a diagnostic accuracy on small bowel morphology similar to X-ray barium follow-through. Although extremely investigated by transabdominal ultrasonography, celiac disease, a common disorder of the small bowel, has been never studied by SICUS. Aim: To asses SICUS characteristics of celiac disease patients. Patients and Methods: SICUS was performed using PeG 4000 as contrast agent. Twenty-three patients with celiac disease at the first diagnosis were enrolled and 30 healthy volunteers, matched for sex and age, were selected as control group. Celiac disease diagnosis was based on anti-gluten, anti-endomysium, and anti-transglutaminase positivity as well as jejunal histology. The following seven echographic parameters were considered: liquid endoluminal content before contrast, loop diameter, Kerckring’ s folds, peristaltic waves, ileal jejunalization, mesenteric lymphoadenomegaly,and Doppler resistance index (RI) of mesenteric superior artery. Statistical analysis was performed by Student’ s t test for unpaired data; one-way analysis of variance was used to correlate echographic and histologic pictures. Results: Loop diameter, Kerckring’ s fold number, peristaltic waves, and Doppler RI appeared to be significantly different between celiac disease patients and controls. Additionally, liquid content, ileal jejunalization, and mesenteric lymphoadenomegaly were present only in the celiacs (52.1% ,47.7% , and 95.6% , respectively), but not in controls. Only Doppler RI values significantly correlated with the histologic degree of damage. Conclusions: SICUS could be a reliable and noninvasive technique to confirm a diagnosis of celiac disease performed using conventional investigations. The possibility of investigating the whole small bowel and the safety of repeating examinations could be useful in the follow-up of celiac patients.

关键词：乳糜泻小肠病变造影成像超声检查随访方法蠕动波肠结阻力指数重复检查组织学检查

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Risk perception and knowledge of COVID-19 in patients with celiac disease

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World Journal of Gastroenterology 2021年第12期27卷 1213-1225页

作者： Jamie Zhen Juan Pablo Stefanolo María de la Paz Temprano Caroline L Seiler Alberto Caminero enrique de-Madaria Miguel Montoro Huguet Vivas Santiago Sonia Isabel Niveloni edgardo Gustavo Smecuol Luis Uzcanga Dominguez elena Trucco Virginia Lopez Carolina Olano Pasquale Mansueto Antonio Carroccio Peter H Green Donald Duerksen Andrew S Day Jason A Tye-Din Julio César Bai Carolina Ciacci elena F Verdú Benjamin Lebwohl M Ines Pinto-Sanchez Department of Medicine Farncombe Family Digestive Health Research InstituteMcMaster University Medical CenterHamilton Health SciencesHamilton L8S4K1ONCanada Department of Medicine Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Department of Pancreatic Unit Hospital General Universitario de AlicanteAlicante 03010Spain Department of Medicine Instituto Aragonés de Ciencias de la Salud(IACS)Zaragoza 50009Spain Department of Medicine Hospital Universitario San Jorge.HuescaZaragoza 50004Spain Department of Gastroenterology Univ Hosp LeonGastroenterol UnitAltos de Nava S-NLeon 24071Spain Department of Medicine Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico DF 14080Mexico Department of Medicine Universidad de la RepublicMontevideo 11800Uruguay Department of Internal Medicine PROMISE DepartmentUniversity of PalermoPalermo 90127Italy Department of Internal Medicine V.Cervello HospitalPROMISE DepartmentUniversity of PalermoPalermo 90127Italy Celiac Disease Center Columbia University Medical CenterColumbia UnivCeliac Dis CtrDiv Digest and Liver DisNew YorkNY 10032United States Department of Medicine St Boniface Gen HospUniversity of ManitobaWinnipeg R2H 2A6Canada Department of Paediatrics University of Otago ChristchurchChristchurch 8041New Zealand Department of Gastroenterology Royal Melbourne HospitalImmunology DivisionWalter and Eliza Hall InstituteMelbourne 3052Australia Department of Medicine Surgery and DentryScuola Medica SalernitanaUniversity of SalernoCeliac Center at the University Hospital San Giovanni di Dio e Ruggi di AragonaSalerno 84131Italy Department of Medicine Farncombe Family Digestive Research InstituteMcMaster UniversityHamilton L8S4K1ONCanada The Celiac Disease Center Columbia UniversityNew YorkNY 10032United States

BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019(COVID-19)in patients with celiac disease(CeD)is similar to that of the general population.However,how patients with CeD perceive their COVID-19 risk may differ from their actual risk.AIM To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their perception.MeTHODS We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics,diet,COVID-19 testing,and risk perceptions of COVID-19 in patients with CeD.Participants were recruited through various celiac associations,clinic visits,and social media.Risk perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general population.Logistic regression was used to determine the influencing factors associated with COVID-19 risk perception,such as age,sex,adherence to a gluten-free diet(GFD),and comorbidities such as cardiac conditions,respiratory conditions,and diabetes.Data was presented as adjusted odds ratios(aORs)ReSULTS A total of 10737 participants with CeD completed the survey.From them,6019(56.1%)patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population.A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD(56.1%vs 26.7%,Pequently,34.8%reported taking extra COVID-19 precautions as a result of their CeD.Members of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members(49.5%vs 57.4%,Per age(aOR:0.99;95%CI:0.99 to 0.99,Pe sex(aOR:0.84;95%CI:0.76 to 0.93,P=0.001),and strict adherence to a GFD(aOR:0.89;95%CI:0.82 to 0.96,P=0.007)were associated with a lower perception of COVID-19 risk and the

关键词： Celiac disease Gluten Risk Infection Knowledge Perception Coronavirus COVID-19

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