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Background Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity and mortality compared with other etiologies. The role of plasma exchange (PE) in this context is still not well established. We aimed to assess the clinical outcomes of patients with HTG-induced AP who underwent PE and compare it with those who did not. Patients and methods We retrospectively evaluated the data of patients who were admitted with HTG-induced AP between January 2013 and May 2018. The endpoint of the study was to assess the clinical outcomes, which included complication rates, mortality, and pancreatitis recurrence rate. Results Overall, 41 patients were included in the final analysis. Of these, 12 (29.2%) underwent PE. Patients undergoing PE had more severe pancreatitis on the basis of the Japanese Severity Score [10 (83.3%) vs. 14 (48.3%), P=0.03, respectively). Although mortality was higher in patients who underwent PE [three (25.0%) vs. zero, P

Introduction Chronic hepatitis C virus (HCV) infection is a major health problem worldwide. The majority of cases involving HCV infection develop into chronic hepatitis because of a failure to develop an effective immune response. Apoptosis of the hepatocytes plays a significant role in the pathogenesis of HCV infection: the interaction between the Fas antigen on hepatocytes and the Fas ligand on T cells corresponds to the main mechanism for hepatocyte damage. Interferon (IFN)-α has antiviral, immunoregulatory, and antiproliferative properties, and apoptosis seems to be a critical event in the action mechanisms of both IFNs. In this study, we aimed to detect any relationship between apoptotic markers in the liver and the response to the treatment. Materials and methods The study included 180 chronic HCV patients treated with IFN and ribavirin in four centers. Apoptotic markers (Fas, Fas ligand, Fas-associated death domain, caspases 3, 8, and 9, and in-situ apoptosis) were studied in the liver. The age, sex of the patients, response to therapy, ALT level, viral load, and genotype were recorded. Results The results of the study showed that the histological activity index and fibrosis correlated with CD95 staining density, caspase-8 intensiveness, and portal and parenchymal Fas ligand scores. The apoptotic parameters of the responsive cases were not significantly different from those of the unresponsive cases. Conclusion The apoptotic parameters studied in liver tissue are associated with inflammation and fibrosis; however, these parameters may not predict response to treatment.

WOS: 000356588500012 PubMed ID: 26043290 ObjectiveRecent studies have suggested that endotoxin-induced cytokines play an important role in nonalcoholic fatty liver disease (NAFLD). Rifaximin is a nonabsorbable antibiotic that might act on Gram-negative bacteria, thereby inhibiting endotoxin proinflammatory cytokine production in patients with NAFLD. Our aim was to investigate the efficacy of rifaximin on NAFLD.MethodsForty-two patients with biopsy-proven NAFLD [15 steatosis, 27 nonalcoholic steatohepatitis (NASH)] were included in this prospective, open-label, observational cohort study. BMI and serum aspartate aminotransferase, alanine aminotransferase (ALT), gamma glutamyl transferase, lipid profile, ferritin, C-reactive protein, glucose, insulin, homeostatic model assessment as well as endotoxin, serum Toll-like receptor 4 (TlR4), interleukin-1 (IL-1), IL-6, IL-10, IL-12, and tumor necrosis factor- (TNF-) levels were measured before and after a 28-day administration of rifaximin (1200mg/daily). Results were analyzed using nonparametric Wilcoxon signed-rank tests.ResultsA mild reduction in the mean BMI (32.36.9 vs. 31.9 +/- 6.8, P=0.02) and a significant reduction in the endotoxin (0.9 +/- 0.34 vs. 0.8 +/- 0.13, P=0.03) and IL-10 (4.08 +/- 0.9 vs. 3.73 +/- 0.7, P=0.006) levels in the NASH group were noted. A significant reduction was observed in serum aspartate aminotransferase (50.4 +/- 39 vs. 33 +/- 14, P=0.01), ALT (72 +/- 48 vs. 45.2 +/- 26.3, P=0.0001), gamma glutamyl transferase (52 +/- 33 vs. 41.2 +/- 21.1, P=0.02), LDL (137 +/- 34 vs. 127 +/- 27.5, P=0.03), and ferritin (142 +/- 214 vs. 89.3 +/- 123, P=0.0001) in the NASH group, but only in ALT (50.4 +/- 26 vs. 35.5 +/- 23.25, P=0.01), and ferritin (73.6 +/- 83 vs. 55 +/- 76, P=0.004) levels decreased significantly in the steatosis group. Treatment with rifaximin did not exert a significant effect on serum levels of TLR-4, IL-1, IL-6, IL-12, or TNF- in either group.ConclusionIn NAFLD and especially in NASH, short-term administration of rifaximin appears to be safe and effective. Scientific Research Project Council of the Bezmialem Vakif University (BAP) [6.2013/4] This work is supported by the Scientific Research Project Council of the Bezmialem Vakif University (BAP No. 6.2013/4)