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Replication of interleukin 23 receptor and autophagy-related 16-like 1 association in adult-and pediatric-onset inflammatory bowel disease in Italy

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World Journal of Gastroenterology 2008年第29期14卷 4643-4651页

作者： Anna Latiano Orazio Palmieri Maria Rosa Valvano Renata D'Incà Salvatore Cucchiara Gabriele Riegler Anna Maria Staiano Sandro Ardizzone Salvatore Accomando Gian Luigi de Angelis Giuseppe Corritore Fabrizio Bossa Vito Annese U.U. O.O. di gastroenterologia ed Endoscopia Ospedale IRCCS-CSSSan Giovanni Rotondo (Fg) 71013 Italy Cattedra di gastroenterologia Università di PadovaPadova 35122 Italy Clinica Pediatrica Università "La Sapienza" Roma 00185 Italy Cattedra di gastroenterologia Università di NapoliNapoli 80131 Italy Clinica Pediatrica Università di Napoli Napoli 80131 Italy Unità di gastroenterologia Ospedale "Sacco" Milano 20157 Italy Clinica Pediatrica Università di Palermo Palermo 90128 Italy Clinica Pediatrica Università di Parma Parma 43100 Italy

AIM: To investigate gene variants in a large Italian inflammatory bowel disease (IBD) cohort, and to analyze the correlation of sub-phenotypes (including age at diagnosis) and epistatic interaction with other IBD genes. METHODS: Total of 763 patients with Crohn's disease (CD, 189 diagnosed at age 273 trios) were included in the study. The rs2241880 [autophagy-related 16-like 1 (ATG16L1)], rs11209026 and rs7517847 [interleukin 23 receptor (IL23R)], rs2066844, rs2066845, rs2066847 (CARD15), rs1050152 (OCTN1), and rs2631367 (OCTN2) gene variants were genotyped. RESULTS: The frequency of G allele of ATG16L1 SNP (Ala197Thr) was increased in patients with CD compared with controls (59% vs 54% respectively) (OR = 1.25, CI = 1.08-1.45, P = 0.003), but not in UC (55%). The frequency of A and G (minor) alleles of Arg381Gln, rs11209026 and rs7517847 variants of IL23R were reduced significantly in CD (4%, OR = 0.62, CI = 0.45-0.87, P = 0.005; 28%, OR = 0.64, CI = 0.55-0.75, P 2 genes, although both gene variants were associated with pediatric-onset disease. CONCLUSION: The present study confirms the association of IL23R polymorphisms with IBD, and ATG16L1 with CD, in both adult- and pediatric-onset subsets in our study population.

关键词：肠炎肠溃疡结肠疾病遗传因素

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Colonoscopic evaluation of hematochezia in low and average risk patients for colorectal cancer:A prospective study

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World Journal of Gastroenterology 2006年第45期12卷 7304-7308页

作者： Puglisi Carlo Russo Francesco Paolo Barbera Carmelo Incarbone Salvatore Aprile Giuseppe Bonanno Giacomo Russo Antonio Cattedra di gastroenterologia Università di Catania Azienda Ospedaliero Universitaria Policlinico-Catania Italy

AIM: To relate the endoscopic findings in patients with hematochezia with regard to age in “low and average risk” for colorectal cancer (CRC) and to localize signifi cant lesions in order to identify patients who need sigmoidoscopy or total colonoscopy. METHODS: This prospective study was performed in an open access GI endoscopy unit. Out of 4322 consecutive patients undergoing colonoscopy, 918 reported hema- tochezia. The fi nal study group comprized 180 patients aged below 45 and 237 over 45. Main exclusion criteria were a 1st-degree family history of colorectal carcinoma, patients reporting blood mixed with stools and/or pro- gressive colonic symptoms, or patients who had under- gone colon surgery for neoplastic lesions. RESULTS: Total colonoscopy could be performed in 96% of patients. Abnormal findings were observed in 34.3% of the younger and in 65.7% of the older ones. Findings were the presence of polyps in the distal colon (n = 2) and IBD in the proximal colon (n = 29) in the group of the younger patients, and polyps (n = 15), IBD (n = 13), and carcinoma (n = 6, 4 of the lesions were located proximal to the splenic flexure) in the elderly. Our f indings suggest that the diagnostic potential of total colonoscopy in patients younger than 45 referring scant hematochezia, is not mandatory. By exploring only the distal tract of the colon we have misdiagnosed two cases of IBD located in the ascending colon. In this group of patients additional risk factors must be identifi ed before performing a total colonoscopy. Regarding the patients older than 45 yr, the exploration of the distal colon would have led to our overlooking a carcinoma, two neoplastic polyps and one IBD located in the proximal colon. CONCLUSION: Young patients with scant hematochezia but without risk factors for neoplasia do not need a totalcolonoscopy, whereas is mandatory performing a total colonoscopy in older patients even in the presence of anal pathology.

关键词：直肠癌结肠过敏结肠镜检查便血

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Effect of omeprazole on symptoms and ultrastructural esophageal damage in acid bile reflux

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World Journal of Gastroenterology 2005年第12期11卷 1876-1880页

作者： Carlo Calabrese Anna Fabbri Mauro Bortolotti Giovanna Cenacchi Scialpi Carlo Desiree Zahlane Mario Miglioli Giulio Di Febo Dipartimento di Medicina Interna e gastroenterologia

AIM: To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER.METHODS: We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetry.Patients underwent endoscopy and biopsies were taken from the distal esophagus. Specimens were analyzed at histology and transmission electron microscopy (TEM).Patients were treated with omeprazole 40 mg/d for 3 mo and then endoscopy with biopsies was repeated. Patients with persistent heartburn and/or with an incomplete recovery of DIS were treated for 3 more months and endoscopy with biopsies was performed.RESULTS: Nine patients had a non-erosive reflux disease at endoscopy (NERD) while 6 had erosive esophagitis (ERD). At histology, of the 6 patients with erosive esophagus,5 had mild esophagitis and 1 moderate esophagitis. No patients with NERD showed histological signs of esophagitis.After 3 mo of therapy, 13/15 patients (86.7%, P＜0.01)showed a complete recovery of DIS and disappearance of heartburn. Of the 2 patients treated for 3 more months,complete recovery of DIS and heartburn were achieved in one.CONCLUSION: Three or 6 mo of omeprazole therapy led to a complete regression of the ultrastructural esophageal damage in 86.7% and in 93% of patients with DGER, NERD and ERD respectively. The ultrastructural recovery of the epithelium was accompanied by regression of heartburn in all cases.

关键词：食道损伤胆汁逆流奥美拉唑药物治疗

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Aspirin inhibits cell viability and mTOR downstream signaling in gastroenteropancreatic and bronchopulmonary neuroendocrine tumor cells

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World Journal of Gastroenterology 2014年第29期20卷 10038-10049页

作者： Matilde Spampatti George Vlotides Gerald Spttl Julian Maurer Burkhard Gke Christoph J Auernhammer Department of Internal Medicine Ⅱ University-Hospital Campus GrosshadernInterdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System (GEPNET-KUM)Ludwig-Maximilians-University of Munich U.O.C.Gastroenterologia 2 Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Università degli Studi di Milano

AIM:To investigate the effect of aspirin on neuroendocrine tumor(NET)cell growth and signaling in vitro.METHODS:Human pancreatic BON1,bronchopulmonary NCI-H727 and midgut GOT1 neuroendocrine tumor cells were treated with different concentrations of aspirin(from 0.001 to 5 mmol/L),and the resulting effects on metabolic activity/cell proliferation were measured using cell proliferation assays and SYBR-DNAlabeling after 72,144 and 216 h of incubation.The effects of aspirin on the expression and phosphorylation of several critical proteins that are involved in the most common intracellular growth factor signaling pathways(especially Akt protein kinase B)and mammalian target of rapamycin(mTOR)were determined by Western blot analyses.Propidium iodide staining and flow cytometry were used to evaluate changes in cell cycle distribution and apoptosis.Statistical analysis was performed using a 2-tailed Student’s t-test to evaluate the proliferation assays and cell cycle analyses.The results are expressed as the mean±SD of 3 or 4 independently performed experiments.Statistical significance was set at P27 and GOT1 cells in a time-and dose-dependent manner.Significant effects were observed at starting doses of 0.5-1 mmol/L and peaked at 5 mmol/L.For instance,after treatment with 1 mmol/L aspirin for 144 h,the viability of pancreatic BON1 cells decreased to 66%±13%(P27 cells decreased to 53%±8%(P21 and reduced expression of cyclindependent kinase 4 and cyclin D3.Aspirin suppressed mTOR downstream signaling,evidenced by the reduced phosphorylation of the mTOR substrates 4E binding protein 1,serine/threonine kinase P70S6K and S6 ribosomal protein and inhibited glycogen synthase kinase3 activity.We o

关键词： Neuroendocrine tumors Aspirin Cell Viability Mamma

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Ileal lesions in patients with ulcerative colitis after ileo-rectal anastomosis:Relationship with colonic metaplasia

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World Journal of Gastroenterology 2008年第34期14卷 5290-5300页

作者： Livia Biancone Emma Calabrese Giampiero Palmieri Carmelina Petruzziello Sara Onali Giuseppe Sigismondo Sica Marta Cossignani Giovanna Condino Kiron Moy Das Francesco Pallone Cattedra di gastroenterologia Dipartimento di Medicina InternaUniversità di "Tor Vergata" Cattedra di Anatomia ed Istologia Patologica Università di "Tor Vergata" Cattedra di gastroenterologia Dipartimento di Medicina InternaUniversità di "Tor Vergata" Cattedra di Chirurgia Generale Università di "Tor Vergata" Cattedra di gastroenterologia Dipartimento di Medicina Interna Università di "Tor Vergata" GI Unit Department of Gastroenterology & Hepatology University of Medicine & Dentistry of New Brunswick

AIM:To assess whether in ulcerative colitis (UC) patients with ileo-rectal anastomosis (IRA), ileal lesions may develop in the neo-terminal-ileum and their possible relation with phenotypic changes towards colonic epithelium. METHODS: A total of 19 patients with IRA under regular follow up were enrolled, including 11 UC and 8 controls (6 Crohn’s disease, CD; 1 familial adenomatous polyposis, FAP; 1 colon cancer, colon K). Ileal lesions were identifi ed by ileoscopy with biopsies taken from the ileum (involved and uninvolved) and from the rectal stump. Staining included HE and immunohistochemistry using monoclonal antibodies against colonic epithelial protein CEP (Das-1) and human tropomyosin isoform 5, hTM5 (CG3). Possible relation between development of colonic metaplasia and ileal lesions was investigated.RESULTS: Stenosing adenocarcinoma of the rectal stump was detected in 1 UC patient. The neo-terminal ileum was therefore investigated in 10/11 UC patients. Ileal ulcers were detected in 7/10 UC, associated with colonic metaplasia in 4/7 (57.1%) and Das-1 and CG3 reactivity in 3/4 UC. In controls, recurrence occurred in 4/6 CD, associated with colonic metaplasia in 3/4 and reactivity with Das-1 and CG3 in 2/3. CONCLUSION: Present fi ndings suggest that in UC, ileal lesions associated with changes towards colonic epithelium may develop also after IRA. Changes of the ileal content after colectomy may contribute to the development of colonic metaplasia, leading to ileal lesions both in the pouch and in the neo-terminal ileum after IRA.

关键词：溃疡性结肠炎肠阻塞回盲肠吻合术结肠组织转化

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Management of hepatocellular carcinoma in the elderly

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World Journal of Hepatology 2015年第11期7卷 1521-1529页

作者： Mauro Borzio Elena Dionigi Giancarlo Parisi Ivana Raguzzi Rodolfo Sacco Unità di gastroenterologia Azienda Ospedaliera di Melegnano Dipartimento di Medicina Ospedale Santa Maria del Prato Unità di gastroenterologia Ospedale Cisanello

Mean age of hepatocellular carcinoma(HCC) patients has been progressively increasing over the last decades and ageing of these patients is becoming a real challenge in every day clinical practice. Unfortunately, international guidelines on HCC management do not address this problem exhaustively and do not provide any specific recommendation. We carried out a literature search in MEDLINE database for studies reporting on epidemiology, clinical characteristics and treatment outcome of HCC in elderly patients. Available data seem to indicate that in elderly patients the outcome of HCC is mostly influenced by liver function and tumor stage rather than by age and the latter should not influence treatment allocation. Age is not a risk for resection and older patients with resectable HCC and good liver function could gain benefit from surgery. Mild comorbidities do not seem a contraindication for surgery in aged patients. Conversely, major resection in elderly, even when performed in experienced high-volume centres, should be avoided. Both percutaneous ablation and transarterial chemoembolization are not contraindicated in aged patients and safety profile of these procedures is acceptable. Sorafenib is a viable option for advanced HCC in elderly provided that a careful evaluation of concomitant comorbidities, particularly cardiovascular ones, is taken into account. Available data seem to suggest that in either elderly and younger, treatment is a main predictor of outcome. Consequently, a nihilistic attitude of physicians towards under- or no-treatment of aged patients should not be longer justified.

关键词： Hepatocarcinoma Epidemiology Cirrhosis Elderly Treatment

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A new heparin fragment decreases liver ischemia-reperfusion injury

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Hepatobiliary & Pancreatic Diseases International 2022年第2期21卷 190-192页

作者： Enio R Vasques Estela RR Figueira Joel A Rocha-Filho Cinthia Lanchotte Jorge LS Ximenes Helena B Nader Ivarne LS Tersariol Marcelo A Lima Tiago Rodrigues JoséEM Cunha Eleazar Chaib Luiz AC D’Albuquerque Flávio HF Galvão Laboratorio de Investigaçao Medica 37 Departamento de GastroenterologiaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão Paulo 01246-903Brazil Departamento de gastroenterologia Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil Disciplina de Anestesiologia Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil Departamento de Bioquimica Universidade Federal de São PauloSão PauloBrazil Universidade Federal do ABC Santo AndreSão PauloBrazil Serviço de Transplante de Figado e Orgaos do Aparelho Digestivo Departamento de GastroenterologiaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil

To the Editor:Ischemia-reperfusion injury following surgery and transplantation can lead to irreversible multiorgan failure.Intracellular calcium overload is associated to cellular death during ischemiareperfusion.A recently discovered heparin fragment (HF),trisulfated disaccharide (TD),that acts on sodium-calcium exchanger(NCX) decreasing intracellular Ca^(2+),showed effectiveness on protecting hepatocytes from ischemia-reperfusion injury [1].

关键词： irreversible heparin injury

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Changes in nutritional status after liver transplantation

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World Journal of Gastroenterology 2014年第31期20卷 10682-10690页

作者： Michela Giusto Barbara Lattanzi Vincenza Di Gregorio Valerio Giannelli Cristina Lucidi Manuela Merli Ⅱ gastroenterologia Dipartimento di Medicina Clinica "Sapienza" Università di Roma00185 Roma Italy

Chronic liver disease has an important effect on nutritional status, and malnourishment is almost universally present in patients with end-stage liver disease who undergo liver transplantation. During recent decades,a trend has been reported that shows an increase in number of patients with end-stage liver disease and obesity in developed countries. The importance of carefully assessing the nutritional status during the workup of patients who are candidates for liver replacement is widely recognised. Cirrhotic patients with depleted lean body mass(sarcopenia) and fat deposits have an increased surgical risk; malnutrition may further impact morbidity, mortality and costs in the post-transplantation setting. After transplantation and liver function is restored, many metabolic alterations are corrected,dietary intake is progressively normalised, and lifestyle changes may improve physical activity. Few studies have examined the modifications in body composition that occur in liver recipients. During the first 12 mo, the fat mass progressively increases in those patients who had previously depleted body mass, and the muscle mass recovery is subtle and non-significant by the end of the first year. In some patients, unregulated weight gain may lead to obesity and may promote metabolicdisorders in the long term. Careful monitoring of nutritional changes will help identify the patients who are at risk for malnutrition or over-weight after liver transplantation. Physical and nutritional interventions must be investigated to evaluate their potential beneficial effect on body composition and muscle function after liver transplantation.

关键词： Liver transplantation Sarcopenia Malnutrition Obes

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A practical approach to the diagnosis of autoimmune pancreatitis

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World Journal of Gastroenterology 2011年第16期17卷 2076-2079页

作者： Luca Frulloni Antonio Amodio Anna Maria Katsotourchi Italo Vantini Department of Medicine University of Verona Cattedra di gastroenterologia Policlinico GB Rossi

Autoimmune pancreatitis is a disease characterized by specific pathological features,different from those of other forms of pancreatitis,that responds dramatically to steroid therapy.The pancreatic parenchyma may be diffusely or focally involved with the possibility of a low-density mass being present at imaging,mimicking pancreatic cancer.Clinically,the most relevant problems lie in the diagnosis of autoimmune pancreatitis and in distinguishing autoimmune pancreatitis from pancreatic cancer.Since in the presence of a pancreatic mass the probability of tumour is much higher than that of pancreatitis,the physician should be aware that in focal autoimmune pancreatitis the first step before using steroids is to exclude pancreatic adenocarcinoma.In this review,we briefly analyse the strategies to be followed for a correct diagnosis of autoimmune pancreatitis.

关键词：自身免疫性胰腺炎诊断病理特征胰腺癌成像质量类固醇低密度

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Higher cardiovascular risk scores and liver fibrosis risk estimated by biomarkers in patients with metabolic-dysfunction-associated fatty liver disease

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World Journal of Hepatology 2022年第8期14卷 1633-1642页

作者： Giovanni Alejandro Salgado Alvarez Samanta Mayanin Pinto Galvez Uriel Garcia Mora Ana Delfina Cano Contreras Cristina Durán Rosas Bryan Adrián Priego-Parra Arturo Triana Romero Mercedes Amieva Balmori Federico Roesch Dietlen Sophia Eugenia Martinez Vazquez Ines Osvely Mendez Guerrero Luis Alberto Chi-Cervera Raúl Bernal Reyes Leonardo Alberto Martinez Roriguez Maria Eugenia Icaza Chavez Jose Maria Remes Troche Instituto de Investigaciones Médico-biologicas Universidad VeracruzanaVeracruz 91700VeracruzMexico Department of Gastroenterología Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico 14080MéxicoMexico Clínica de Especialidades Gastrointestinales y Hepáticas Hospital Star MedicaMerida 97133YucatanMexico Department of gastroenterologia Sociedad Española de BeneficenciaPachuca 42000HidalgoMexico Department of gastroenterologia Clínica de Rehabilitación Metabólica Digestiva y HepáticaMexico 14080MexicoMexico Department of gastroenterologia Hospital Star Médica de MéridaMerida 97133YucatanMexico

BACKGROUND The definition of metabolic-dysfunction-associated fatty liver disease(MAFLD)allows identification of metabolically complicated patients.Fibrosis risk scores are related to cardiovascular risk(CVR)scores and could be useful for the identification of patients at risk of systemic complications.AIM To evaluate the relationship between MAFLD and CVR using the Framingham risk score in a group of Mexican patients.METHODS Cross-sectional,observational and descriptive study carried out in a cohort of 585 volunteers in the state of Veracruz with MAFLD criteria.The risk of liver fibrosis was calculated with aspartate aminotransferase-to-platelet ratio index,nonalcoholic fatty liver disease score and fibrosis-4,as well as with transient hepatic elastography with Fibroscan~?.The CVR was determined by the Framingham system.RESULTS One hundred and twenty-five participants(21.4%)with MAFLD criteria were evaluated,average age 54.4 years,63.2%were women,body mass index 32.3 kg/m~2.The Framingham CVR was high in 43 patients(33.9%).Transient elastography was performed in 55.2%of volunteers;39.1%with high CVR and predominance in advanced fibrosis(F3–F4).The logistic regression analysis showed that liver fibrosis,diabetes and hypertension independently increased CVR.CONCLUSION One of every three patients with MAFLD had a high CVR,and in those with high fibrosis risk,the CVR risk was even greater.

关键词： Fatty liver Cardiovascular risk Hepatic steatosis Fibrosis Liver disease

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