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101. SEC62 and SEC63 Expression in Hepatocellular Carcinoma and Tumor-Surrounding Liver Tissue

Author

Johannes Linxweiler, Susanne N. Weber, Frank Lammert, Markus Casper, Matthias Glanemann, Maximilian Linxweiler, and Richard Zimmermann

Subjects
Pathology, medicine.medical_specialty, Liver tumor, business.industry, Gastroenterology, medicine.disease, Chronic liver disease, 03 medical and health sciences, 0302 clinical medicine, SEC63, SEC62, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Gene expression, Medicine, Immunohistochemistry, 030211 gastroenterology & hepatology, Surgery, business, Liver cancer
Abstract

Introduction: The endoplasmic reticulum transmembrane proteins Sec61, Sec62, and Sec63 are responsible for the intracellular trafficking of precursor proteins and affect intracellular signaling. SEC62 overexpression has been linked to various human cancers. Our aim was to investigate SEC62 and SEC63 expression in hepatocellular carcinoma (HCC) and surrounding liver tissue. Patients and Methods: Primary liver tissue was collected from 11 consecutive patients (70 ± 9 years; 10 men) who underwent HCC resection. In the HCC and the tumor-surrounding liver tissue we investigated SEC62 und SEC63 mRNA expression using quantitative real-time PCR. For Sec62, immunohistochemistry was performed. Results: SEC62and SEC63 total mRNA contents were significantly (p = 0.001) higher in HCCs (CT 22.5 ± 0.4 and 22.6 ± 0.3) when compared to the surrounding tissue (CT 24.6 ± 0.6 and 25.1 ± 0.9). Using the comparative CTmethod, SEC62 and SEC63 expression in HCC was increased 5- and 8.1-fold, respectively, in comparison to surrounding tissue. For Sec62 immunohistochemistry, the mean immunoreactive scores (IRS) were 7.9 ± 2.9 for HCC and 4.8 ± 1.2 for non-tumorous liver (p = 0.027). The mean IRS in HCC were 5.7 ± 3.5 and 8.9 ± 2.3 for patients without (n = 3) and with tumor recurrence (n = 8), respectively. Conclusions: Overexpression of SEC62 and SEC63 is a common feature of HCC. The role of Sec62 as a prognostic marker for tumor recurrence after surgery and its potential role in treatment stratification must be addressed in future studies.

Published
2021

102. SARS-CoV-2 vaccination rate and SARS-CoV-2 infection of health care workers in aerosol-generating medical disciplines

Author

Anna Muzalyova, Alanna Ebigbo, Maria Kahn, Stephan Zellmer, Albert Beyer, Jonas Rosendahl, Johannes Zenk, Bilal Al-Nawas, Roland Frankenberger, Juergen Hoffmann, Christoph Arens, Frank Lammert, Claudia Traidl-Hoffmann, Helmut Messmann, and Christoph Roemmele

Subjects
aerosol-generating procedures, SARS-CoV-2, perceived risk of infection, vaccination rate, General Medicine, ddc:610
Abstract

Healthcare workers (HCW) who perform aerosol-generating procedures (AGP) are at high risk of SARS-CoV-2 infection. Data on infection rates and vaccination are limited. A nationwide, cross-sectional study focusing on AGP-related specialties was conducted between 3 May 2021 and 14 June 2021. Vaccination rates among HCW, perception of infection risk, and infection rates were analyzed, focusing on the comparison of gastrointestinal endoscopy (GIE) and other AGP-related specialties (NON-GIE), from the beginning of the pandemic until the time point of the study. Infections rates among HCW developed similarly to the general population during the course of the pandemic, however, with significantly higher infections rates among the GIE specialty. The perceived risk of infection was distributed similarly among HCW in GIE and NON-GIE (91.7%, CI: 88.6–94.4 vs. 85.8%, CI: 82.4–89.0; p < 0.01) with strongest perceived threats posed by AGPs (90.8%) and close patient contact (70.1%). The very high vaccination rate (100–80%) among physicians was reported at 83.5%, being significantly more frequently reported than among nurses (56.4%, p < 0.01). GIE had more often stated very high vaccination rate compared with NON-GIE (76.1% vs. 65.3%, p < 0.01). A significantly higher rate of GIE was reported to have fewer concerns regarding infection risk after vaccination than NON-GIE (92.0% vs. 80.3%, p < 0.01).

Published
2022

103. S3-Guideline: Diagnosis and Therapy of Hepatocellular Carcinoma

Author

Sabrina, Voesch, Michael, Bitzer, Joerg, Albert, Peter, Bartenstein, Wolf, Bechstein, Susanne, Bloedt, Thomas, Brunner, Frank, Dombrowski, Matthias, Evert, Markus, Follmann, Christian, La Fougere, Paul, Freudenberger, Andreas, Geier, Eleni, Gkika, Martin, Goetz, Elke, Hammes, Thomas, Helmberger, Ralf-Thorsten, Hoffmann, Wolf-Peter, Hofmann, Peter, Huppert, Achim, Kautz, Gabi, Knoetgen, Juergen, Koerber, David, Krug, Frank, Lammert, Hauke, Lang, Thomas, Langer, Philipp, Lenz, Andreas, Mahnken, Alexander, Meining, Oliver, Micke, Silvio, Nadalin, Johann, Ockenga, Karl-Juergen, Oldhafer, Philipp, Paprottka, Kerstin, Paradies, Philippe, Pereira, Thorsten, Persigehl, Mathias, Plauth, Ruben, Plentz, Juergen, Pohl, Jutta, Riemer, Peter, Reimer, Johanna, Ringwald, Ulrike, Ritterbusch, Elke, Roeb, Barbara, Schellhaas, Peter, Schirmacher, Irene, Schmid, Andreas, Schuler, Dietrich, von Schweinitz, Daniel, Seehofer, Marianne, Sinn, Alexander, Stein, Andreas, Stengel, Nadine, Steubesand, Christian, Stoll, Andrea, Tannapfel, Anne, Taubert, Joerg, Trojan, Ingo, van Thiel, Reina, Tholen, Arndt, Vogel, Thomas, Vogl, Hilke, Vorwerk, Frank, Wacker, Oliver, Waidmann, Heiner, Wedemeyer, Henning, Wege, Dane, Wildner, Christian, Wittekind, Marcus-Alexander, Worns, Peter, Galle, Nisar, Malek, Sabrina, Voesch, Michael, Bitzer, Joerg, Albert, Peter, Bartenstein, Wolf, Bechstein, Susanne, Bloedt, Thomas, Brunner, Frank, Dombrowski, Matthias, Evert, Markus, Follmann, Christian, La Fougere, Paul, Freudenberger, Andreas, Geier, Eleni, Gkika, Martin, Goetz, Elke, Hammes, Thomas, Helmberger, Ralf-Thorsten, Hoffmann, Wolf-Peter, Hofmann, Peter, Huppert, Achim, Kautz, Gabi, Knoetgen, Juergen, Koerber, David, Krug, Frank, Lammert, Hauke, Lang, Thomas, Langer, Philipp, Lenz, Andreas, Mahnken, Alexander, Meining, Oliver, Micke, Silvio, Nadalin, Johann, Ockenga, Karl-Juergen, Oldhafer, Philipp, Paprottka, Kerstin, Paradies, Philippe, Pereira, Thorsten, Persigehl, Mathias, Plauth, Ruben, Plentz, Juergen, Pohl, Jutta, Riemer, Peter, Reimer, Johanna, Ringwald, Ulrike, Ritterbusch, Elke, Roeb, Barbara, Schellhaas, Peter, Schirmacher, Irene, Schmid, Andreas, Schuler, Dietrich, von Schweinitz, Daniel, Seehofer, Marianne, Sinn, Alexander, Stein, Andreas, Stengel, Nadine, Steubesand, Christian, Stoll, Andrea, Tannapfel, Anne, Taubert, Joerg, Trojan, Ingo, van Thiel, Reina, Tholen, Arndt, Vogel, Thomas, Vogl, Hilke, Vorwerk, Frank, Wacker, Oliver, Waidmann, Heiner, Wedemeyer, Henning, Wege, Dane, Wildner, Christian, Wittekind, Marcus-Alexander, Worns, Peter, Galle, and Nisar, Malek

Published
2022

104. Long‐Term Colestyramine Treatment Prevents Cholestatic Attacks in Refractory Benign Recurrent Intrahepatic Cholestasis Type 1 Disease

Author

E Koukoulioti, Susanne N. Weber, Frank Lammert, Thomas Berg, and Athanasia Ziagaki

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, medicine.drug_class, Cholestyramine Resin, Benign Recurrent Intrahepatic Cholestasis, Drug Resistance, Administration, Oral, Cholestasis, Intrahepatic, Disease, Gene mutation, Gastroenterology, Intestinal absorption, 03 medical and health sciences, 0302 clinical medicine, Refractory, Recurrence, Internal medicine, Secondary Prevention, medicine, Humans, Secretion, Hepatology, Bile acid, business.industry, Patient Acuity, Middle Aged, Treatment Outcome, 030104 developmental biology, 030211 gastroenterology & hepatology, Farnesoid X receptor, business
Abstract

Benign recurrent intrahepatic cholestasis (BRIC) is an autosomal recessive cholestatic disease characterized by intermittent cholestatic episodes of variable severity and duration. BRIC type 1 has been linked to gene mutations encoded in the hepatocanalicular transporter ATP8B1.1 It has been suggested that ATP8B1 affects the regulation of the farnesoid X receptor, and thus ATP8B1 deficiency could lead to an imbalance between intestinal absorption of bile acids and hepatic secretion, causing bile acid accumulation.2 The latter aggravates hepatocellular dysfunction leading to a vicious cycle.

Published
2021

105. Ten‐year follow‐up of a randomized controlled clinical trial in chronic hepatitis delta

Author

Michael P. Manns, Fehmi Tabak, Frank Lammert, Markus Cornberg, George N. Dalekos, Kendal Yalcin, Tobias Müller, Svenja Hardtke, Ramazan Idilman, Heiner Wedemeyer, Cihan Yurdaydin, Yilmaz Cakaloglu, Ulus Salih Akarca, M. Wöbse, A. Wranke, Dieter Häussinger, Benjamin Heidrich, Selim Gürel, Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı., Gürel, Selim, EYK-5719-2022, Yurdaydın, Cihan, Wranke, Anika, Hardtke, Svenja, Heidrich, Benjamin, Dalekos, George, Yalçın, Kendal, Tabak, Fehmi, Çakaloğlu, Yılmaz, Akarca, Ulus S., Lammert, Frank, Haeussinger, Dieter, Mueller, Tobias, Woebse, Michael, Manns, Michael P., İdilman, Ramazan, Cornberg, Markus, Wedemeyer, Heiner, School of Medicine, Ege Üniversitesi, and Dicle Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıklar Ana Bilim Dalı, Gastroenteroloji Bilim Dalı

Subjects
Male, medicine.medical_treatment, Gamma glutamyl transferase blood level, Liver transplantation, Gastroenterology, Albumin blood level, Virus-RNA, law.invention, Medicine, Gastroenterology and hepatology, Infectious diseases, Virology, Delta virus, 0302 clinical medicine, Pegylated interferon, Adefovir, Adefovir dipivoxil, Treatment outcome, Interferon therapy, Clinical outcome, Flares, Retrospective study, Randomized controlled trial, Creatinine, 030211 gastroenterology & hepatology, Infection, Human, medicine.medical_specialty, Recombinant protein, Gamma glutamyltransferase, Virus RNA, Hepatitis, chronic, Treatment refusal, Major clinical study, Aspartate aminotransferase, Article, Treatment duration, 03 medical and health sciences, Alkaline phosphatase, Humans, Creatinine blood level, endpoint, Follow up, Endpoint, medicine.disease, Event free survival, Retrospective studies, Alkaline phosphatase blood level, Child Pugh score, Gastroenterology & hepatology, Aspartate aminotransferase blood level, Medizin, clinical outcome, Need, Liver disease, law, Prevalence, delta virus, 030212 general & internal medicine, Chronic hepatitis, Priority journal, Recombinant proteins, Polyethylene glycols, Delta agent hepatitis, Hepatitis D, Death, Combination drug therapy, Infectious Diseases, Hepatitis B surface antigen, Alanine aminotransferase blood level, Female, chronic hepatitis, Viral hepatitis, Liver cancer, medicine.drug, Adult, Treatment withdrawal, End stage liver disease, Drug therapy, combination, Peginterferon alpha2a, Follow-up studies, Decompensated liver cirrhosis, General condition improvement, Internal medicine, medicine, Antivirus agent, Survival rate, Bilirubin blood level, Hepatology, business.industry, Albumin, Bilirubin, Alpha-2b, Hepatitis Delta Virus, Chronic Hepatitis D, Hepatitis B, Kinetics, Antiviral agents, Severity of illness index, Macrogol, Alanine aminotransferase, business, Controlled study
Abstract

Hepatitis delta virus (HDV) infection causes the most severe form of viral hepatitis. PEG-interferon alpha-2a (PEG-IFN alpha-2a) is the only effective treatment but its long-term clinical impact is unclear. the aim of this study was to investigate the long-term outcome after 48 weeks of pegylated interferon alpha-2a therapy. We performed a retrospective follow-up study of the Hep-Net-International-Delta-Hepatitis-Intervention-Study 1 (HIDIT-I trial). Patients had received 48 weeks of treatment with either PEG-IFN alpha-2a plus adefovir dipivoxil (ADV) (Group I), PEG-IFN alpha-2a alone (Group II) or adefovir dipivoxil alone (Group III). Liver-related complications were defined as liver-related death, liver transplantation, liver cancer and hepatic decompensation defined as development of Child-Pugh scores B or C or an increase in Model for End-stage Liver Disease (MELD) scores of five or more points in relation to baseline values. Patients were considered for further analysis when they were retreated with PEG-IFN alpha-2a. Follow-up data (at least 1 visit beyond post-treatment week 24) were available for 60 patients [Group I, (n = 19), Group II (n = 20), Group III (n = 21)]. Mean time of follow-up was 8.9 (1.6 - 13.4) years. 19 patients were retreated with IFN-based therapy: 42% (n = 8) in PEG-IFN alpha-2a arms and 58% (n = 11) in the adefovir only arm. Clinical complications on long-term follow-up occurred in 17 patients and were associated with nonresponse to therapy and baseline cirrhosis. the annual event-free survival rate in patients with cirrhosis vs noncirrhotic patients at year 5 and 10 was 70% vs 91% and 35% vs 76%. Long-term follow-up of a large randomized clinical trial suggests that off-treatment HDV RNA response to PEG-IFN alpha-2a treatment leads to improved clinical long-term outcome., German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig; German Liver Foundation; EASL registry grant, This study was funded by the German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig with a grand to the HepNet Study-House, the German Liver Foundation and an EASL registry grant.

Published
2020

106. Die Grenzen des G-DRG-Systems bei der Abbildung von Komplexität in der Universitätsmedizin

Author

M Rathmayer, Britta Siegmund, Julia Mayerle, Heiner Wedemeyer, Markus M. Lerch, Andreas Stallmach, Frank Lammert, and Michael Wilke

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Gastroenterology, medicine, 030211 gastroenterology & hepatology, Hospital reimbursement, 030212 general & internal medicine, University hospital, business
Abstract

ZusammenfassungSeit der Einführung des G-DRG-Systems zur Vergütung der stationären Krankenversorgung im Jahr 2003 werden durch das Institut für das Entgeltsystem im Krankenhaus (InEK) jährlich die Erstattungsbeträge für alle Fallgruppen (DRG) auf der Basis des Mittelwerts der Kostendaten (§-21-KHEntgG-Datensatz) von ca. 200 kalkulierenden Krankenhäusern berechnet. Nach dieser Systematik müsste die eine Hälfte der stationären Leistungserbringer Überschüsse in der Krankenversorgung erwirtschaften, die andere Hälfte Verluste ausweisen. Trotz langjähriger Optimierung ihrer Kosten weisen jährlich zwei Drittel der Universitätsklinika operative Defizite aus, unter den nicht universitären Häusern sind es dagegen 29 %. Die Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) hat als wissenschaftliche Fachgesellschaft seit 2012 von 74 für das InEK kalkulierenden und mit der DGVS kooperierenden Krankenhäusern die anonymisierten Kostendaten von mehr als 7 Mio. Abrechnungsfällen ausgewertet, um damit eine sachgerechtere Darstellung gastroenterologischer DRG durch datenbasierte Anträge an das InEK zu ermöglichen. Diese Daten wurden jetzt verwendet, um an drei Beispielen repräsentativer DRG und Operationen- und Prozedurenschlüssel (OPS) (hepatische Enzephalopathie bei Leberzirrhose, endoskopische Leistungsgruppen und Behandlungskosten von zwischen Krankenhäusern für eine Intervention verlegten Patienten) die Möglichkeiten und Grenzen der sachgerechten Darstellung universitätsmedizinischer Leistungserbringung im G-DRG-System zu untersuchen. Die Analyse ergibt, dass eine ökonomisch angemessene Kostenabbildung der komplexeren und schwerer erkrankten Patienten an den Universitätsklinika im G-DRG-System nicht durch Korrekturen oder eine Weiterdifferenzierung innerhalb des bestehenden Systems möglich ist. Selbst in Fallgruppen, in denen eine Korrektur möglich wäre, ist sie im bestehenden System teilweise untersagt. Einem weiteren Anstieg des operativen Defizits der Universitätsklinika in der Krankenversorgung (zuletzt kumulativ 300 Mio. Euro) kann nur durch entweder einen fallbezogenen Systemzuschlag oder die Trennung eines universitätsmedizinischen U-DRG-Systems vom allgemeinen G-DRG-System entgegengewirkt werden.

Published
2020

107. Synergistic effects of extracellular vesicle phenotyping and AFP in hepatobiliary cancer differentiation

Author

Joanna Ligocka, Mateusz Rzucidło, Hanna Sänger, Maria A. Gonzalez-Carmona, Christoph Kahlert, Zeno Sparchez, Sabine K. Urban, Artur Słomka, Beata Kruk, Mikel Azkargorta, Tudor Mocan, Jesus M. Banales, Piotr Milkiewicz, Marcin Krawczyk, Waldemar Patkowski, Marek Krawczyk, Krzysztof Zieniewicz, Arnulf Willms, Krzysztof Gutkowski, Robert Schwab, Wacław Hołówko, Frank Lammert, Christian P. Strassburg, Henrike Julich-Haertel, Miroslaw Kornek, Wojciech Wystrychowski, Krzysztof Jankowski, Joanna Raszeja-Wyszomirska, Łukasz Krupa, Robert Król, Aliona Wöhler, and Sebastian Gehlert

Subjects
Carcinoma, Hepatocellular, Lung Neoplasms, Colorectal cancer, Extracellular Vesicles, 03 medical and health sciences, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, Cancer screening, Tumor Microenvironment, medicine, Humans, Gallbladder cancer, Liquid biopsy, Hepatology, business.industry, Gallbladder, Liver Neoplasms, Cancer, Cell Differentiation, Extracellular vesicle, medicine.disease, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Cancer research, 030211 gastroenterology & hepatology, alpha-Fetoproteins, business
Abstract

Background Biliary cancer, comprising cholangio- and gallbladder carcinomas, is associated with high mortality due to asymptomatic disease onset and resulting late diagnosis. Currently, no robust diagnostic biomarker is clinically available. Therefore, we explored the feasibility of extracellular vesicles (EVs) as a liquid biopsy tool for biliary cancer screening and hepatobiliary cancer differentiation. Methods Serum EVs of biliary cancer, hepatocellular carcinoma, colorectal cancer and non-small cell lung cancer patients, as well as from healthy individuals, were isolated by sequential two-step centrifugation and presence of indicated EVs was evaluated by fluorescence activated cell sorting (FACS) analysis. Results Two directly tumour-related antigen combinations (AnnV+ CD44v6+ and AnnV+ CD44v6+ CD133+ ) and two combinations related to progenitor cells from the tumour microenvironment (AnnV+ CD133+ gp38+ and AnnV+ EpCAM+ CD133+ gp38+ ) were associated with good diagnostic performances that could potentially be used for clinical assessment of biliary cancer and differentiation from other cancer entities. With 91% sensitivity and 69% specificity AnnV+ CD44v6+ EVs showed the most promising results for differentiating biliary cancers from HCC. Moreover using a combined approach of EV levels of the four populations with serum AFP values, we obtained a perfect separation of biliary cancer and HCC with sensitivity, specificity, positive and negative predictive value all reaching 100% respectively. Conclusions EV phenotyping, especially if combined with serum AFP, represents a minimally invasive, accurate liquid biopsy tool that could improve cancer screening and differential diagnosis of hepatobiliary malignancies.

Published
2020

108. Gallensteine – interdisziplinäre Behandlung

Author

Philipp R Scherber, Frank Lammert, Silvia Zúñiga, and Matthias Glanemann

Subjects
medicine.medical_specialty, Pregnancy, business.industry, Cholesterol, medicine.medical_treatment, Gallbladder, General Medicine, Gallstones, Disease, medicine.disease, Gastroenterology, Pathophysiology, chemistry.chemical_compound, medicine.anatomical_structure, Overnutrition, chemistry, Internal medicine, medicine, Cholecystectomy, business
Abstract

Gallstones develop in the gallbladder or the bile ducts. According to their chemical composition, gallstones can be divided into cholesterol stones, which are common, and the rare bile pigment stones. Altogether, up to 20 % of all adults develop gallstones and more than 20 % of them symptoms or complications. Female sex, age, pregnancy, physical inactivity, obesity, overnutrition and genetic factors such as ABCB4 deficiency of the hepatic lecithin transporter are kown risk factors for gallstone formation. In about one half of all patients biliary symptoms precede the three common and potentially life-threatening complications (acute cholecystitis, acute cholangitis and biliary pancreatitis). Although our knowledge about the genetics and pathophysiology of gallstones has improved, current treatment algorithms are predominantly invasive (ERC and surgery). Thus, better strategies are needed to prevent the formation of gallstones in general.

Published
2020

109. Clinical Genomics of NAFLD

Author

Frank Lammert

Subjects
Clinical genomics, business.industry, Medicine, business, Bioinformatics
Published
2020

110. Clinical Genetics of Cholangiopathies

Author

Matthias C. Reichert and Frank Lammert

Subjects
medicine.medical_specialty, business.industry, medicine, Medical genetics, business, Bioinformatics
Published
2020

111. Risk of chemotherapy-associated liver injury (CALI) in PNPLA3 p.148M allele carriers: Preliminary results of a transient elastography-based study

Author

Markus Casper, Susanne N. Weber, Marcin Krawczyk, A Arslanow, Frank Lammert, and Simone Zimmermann

Subjects
Male, Heterozygote, medicine.medical_specialty, medicine.medical_treatment, Antineoplastic Agents, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Fat accumulation, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, Adiponutrin, Prospective Studies, Allele, education, Alleles, Triglycerides, Aged, Liver injury, Chemotherapy, education.field_of_study, Polymorphism, Genetic, Hepatology, business.industry, Membrane Proteins, Lipase, Middle Aged, medicine.disease, Fatty Liver, Liver, 030220 oncology & carcinogenesis, Elasticity Imaging Techniques, Female, 030211 gastroenterology & hepatology, Steatosis, Transient elastography, business, Acyltransferases, TM6SF2
Abstract

Liver steatosis is one of the side effects of chemotherapy. The PNPLA3 p.I148M, TM6SF2 p.E167K and MBOAT7 p.G17E variants represent genetic determinants for progressive liver diseases. Here, we investigate their association with chemotherapy-associated steatosis.Prospectively, we recruited 87 patients undergoing systemic chemotherapy for gastrointestinal cancers. Hepatic fat (controlled attenuation parameter, CAP) and liver stiffness (LSM) were measured non-invasively before the initiation of chemotherapy (T0) and after at least two (T1) and four cycles (T2). Genetic variants were genotyped using allelic discrimination assays.In the final dataset (n = 60) patients demonstrated the following CAP values: T0 - 215.0 ± 55.7 dB/m, T1 - 223.3 ± 53.6 dB/m, T2 - 223.4 ± 56.7 dB/m, consistent with mild steatosis. Initial CAP correlated with BMI (P 0.01) and serum triglyceride concentrations (P = 0.03). Whereas at T0 none of the variants was associated with CAP or LSM, carriers of the prosteatotic PNPLA3 p.148M allele showed significantly (P = 0.008) higher steatosis at T1 as compared to patients carrying the homozygous wild-type genotype [II].Our preliminary results show that patients carrying the PNPLA3 p.I148 M risk allele might be prone to hepatic fat accumulation during chemotherapy. Further studies are be needed to validate the clinical value of these findings.

Published
2020

112. Genetic variation in

Author

Stephan, Buch, Hamish, Innes, Philipp Ludwig, Lutz, Hans Dieter, Nischalke, Jens U, Marquardt, Janett, Fischer, Karl Heinz, Weiss, Jonas, Rosendahl, Astrid, Marot, Marcin, Krawczyk, Markus, Casper, Frank, Lammert, Florian, Eyer, Arndt, Vogel, Silke, Marhenke, Johann, von Felden, Rohini, Sharma, Stephen Rahul, Atkinson, Andrew, McQuillin, Jacob, Nattermann, Clemens, Schafmayer, Andre, Franke, Christian, Strassburg, Marcella, Rietschel, Heidi, Altmann, Stefan, Sulk, Veera Raghavan, Thangapandi, Mario, Brosch, Carolin, Lackner, Rudolf E, Stauber, Ali, Canbay, Alexander, Link, Thomas, Reiberger, Mattias, Mandorfer, Georg, Semmler, Bernhard, Scheiner, Christian, Datz, Stefano, Romeo, Stefano, Ginanni Corradini, William Lucien, Irving, Joanne R, Morling, Indra Neil, Guha, Eleanor, Barnes, M Azim, Ansari, Jocelyn, Quistrebert, Luca, Valenti, Sascha A, Müller, Marsha Yvonne, Morgan, Jean-François, Dufour, Jonel, Trebicka, Thomas, Berg, Pierre, Deltenre, Sebastian, Mueller, Jochen, Hampe, and Felix, Stickel

Abstract

Hepatocellular carcinoma (HCC) often develops in patients with alcohol-related cirrhosis at an annual risk of up to 2.5%. Some host genetic risk factors have been identified but do not account for the majority of the variance in occurrence. This study aimed to identify novel susceptibility loci for the development of HCC in people with alcohol related cirrhosis.Patients with alcohol-related cirrhosis and HCC (cases: n=1214) and controls without HCC (n=1866), recruited from Germany, Austria, Switzerland, Italy and the UK, were included in a two-stage genome-wide association study using a case-control design. A validation cohort of 1520 people misusing alcohol but with no evidence of liver disease was included to control for possible association effects with alcohol misuse. Genotyping was performed using the InfiniumGlobal Screening Array (V.24v2, Illumina) and the OmniExpress Array (V.24v1-0a, Illumina).Associations with variants rs738409 inThis study identifies rs2242652 in

Published
2022

113. Hepatobiliary phenotypes of adults with alpha-1 antitrypsin deficiency

Author

Alice M Turner, David A. Lomas, Alexa Nuñez, Sabina Janciauskiene, William J.H. Griffiths, Christian Trautwein, Joan Genescà, Michael Trauner, John R. Hurst, Jef Verbeek, Matthias C. Reichert, Guilherme Macedo, Ravi Mahadeva, Mònica Pons, Aleksander Krag, Rui Gaspar, V Pereira, Heinz Zoller, Catarina Gomes, Mattias Mandorfer, Barbara Burbaum, Frank Lammert, V Woditsch, Paul Ellis, Aileen Marshall, Douglas Thorburn, Nadine T. Gaisa, Karim Hamesch, Joanna Chorostowska-Wynimko, Luís Jasmins, Malin Fromme, Rodrigo Liberal, Pavel Strnad, Frederik Nevens, Noel G. McElvaney, Marc Miravitlles, Virginia Clark, Bibek Gooptu, Benedikt Schaefer, Katrine Holtz Thorhauge, Carolin V. Schneider, Nelia Abreu, Kai Markus Schneider, Federica Benini, Fromme, Malin [0000-0003-0382-5705], Hamesch, Karim [0000-0002-1702-2746], Reichert, Matthias C [0000-0002-8192-0575], Mandorfer, Mattias [0000-0003-2330-0017], Gaspar, Rui [0000-0003-0332-3844], Trauner, Michael [0000-0002-1275-6425], Krag, Aleksander [0000-0002-9598-4932], Gooptu, Bibek [0000-0002-5223-1121], Hurst, John R [0000-0002-7246-6040], Lomas, David A [0000-0003-2339-6979], Strnad, Pavel [0000-0002-7122-6379], and Apollo - University of Cambridge Repository

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, liver cirrhosis, liver, Gastroenterology, Cohort Studies, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Cholelithiasis, Fibrosis, alpha 1-Antitrypsin Deficiency, Internal medicine, Diabetes mellitus, Genotype, Prevalence, medicine, Humans, cancer, Aged, Alpha 1-antitrypsin deficiency, business.industry, Liver Neoplasms, fibrosis, Cancer, Gallstones, Middle Aged, medicine.disease, United Kingdom, Phenotype, 030228 respiratory system, Case-Control Studies, Female, 030211 gastroenterology & hepatology, business
Abstract

ObjectiveAlpha-1 antitrypsin deficiency (AATD) is a common, potentially lethal inborn disorder caused by mutations in alpha-1 antitrypsin (AAT). Homozygosity for the ‘Pi*Z’ variant of AAT (Pi*ZZ genotype) causes lung and liver disease, whereas heterozygous ‘Pi*Z’ carriage (Pi*MZ genotype) predisposes to gallstones and liver fibrosis. The clinical significance of the more common ‘Pi*S’ variant remains largely undefined and no robust data exist on the prevalence of liver tumours in AATD.DesignBaseline phenotypes of AATD individuals and non-carriers were analysed in 482 380 participants in the UK Biobank. 1104 participants of a multinational cohort (586 Pi*ZZ, 239 Pi*SZ, 279 non-carriers) underwent a comprehensive clinical assessment. Associations were adjusted for age, sex, body mass index, diabetes and alcohol consumption.ResultsAmong UK Biobank participants, Pi*ZZ individuals displayed the highest liver enzyme values, the highest occurrence of liver fibrosis/cirrhosis (adjusted OR (aOR)=21.7 (8.8–53.7)) and primary liver cancer (aOR=44.5 (10.8–183.6)). Subjects with Pi*MZ genotype had slightly elevated liver enzymes and moderately increased odds for liver fibrosis/cirrhosis (aOR=1.7 (1.2–2.2)) and cholelithiasis (aOR=1.3 (1.2–1.4)). Individuals with homozygous Pi*S mutation (Pi*SS genotype) harboured minimally elevated alanine aminotransferase values, but no other hepatobiliary abnormalities. Pi*SZ participants displayed higher liver enzymes, more frequent liver fibrosis/cirrhosis (aOR=3.1 (1.1–8.2)) and primary liver cancer (aOR=6.6 (1.6–26.9)). The higher fibrosis burden was confirmed in a multinational cohort. Male sex, age ≥50 years, obesity and the presence of diabetes were associated with significant liver fibrosis.ConclusionOur study defines the hepatobiliary phenotype of individuals with the most relevant AATD genotypes including their predisposition to liver tumours, thereby allowing evidence-based advice and individualised hepatological surveillance.

Published
2022

114. Variants APOE (rs429358) and TM6SF2 (rs187429064) modify the risk of hepatocellular carcinoma

Author

Hamish Innes, HansDieter Nischalke, KarlHeinz Weiss, Daniel Gotthardt, Neil Guha, Eleanor Barnes, Will Irving, Janett Fischer, Jonas Rosendahl, Markus Casper, Frank Lammert, PhilipL Lutz, Sebastian Mueller, Georg Semmler, Florian Eyer, Johann von Felden, Alexander Link, Arndt Vogel, JensU Marquardt, Stefan Sulk, Christian Datz, Thomas Reiberger, Clemens Schafmayer, Thomas Berg, Jochen Hampe, Felix Stickel, and Stephan Buch

Published
2022

120. Prognostic performance of the 'DICA' endoscopic classification and the 'CODA' score in predicting clinical outcomes of diverticular disease: an international, multicentre, prospective cohort study

Author

Antonio, Tursi, Giovanni, Brandimarte, Francesco, Di Mario, Walter, Elisei, Marcello, Picchio, Leonardo, Allegretta, Maria Laura, Annunziata, Mauro, Bafutto, Gabrio, Bassotti, Maria Antonietta, Bianco, Raffaele, Colucci, Rita, Conigliaro, Dan, Dumitrascu, Ricardo, Escalante, Luciano, Ferrini, Giacomo, Forti, Marilisa, Franceschi, Maria Giovanna, Graziani, Frank, Lammert, Giovanni, Latella, Giovanni, Maconi, Gerardo, Nardone, Lucia, Camara de Castro Oliveira, Enio, Chaves Oliveira, Alfredo, Papa, Savvas, Papagrigoriadis, Anna, Pietrzak, Stefano, Pontone, Tomas, Poskus, Giuseppe, Pranzo, Matthias Christian, Reichert, Stefano, Rodinò, Jaroslaw, Regula, Giuseppe, Scaccianoce, Franco, Scaldaferri, Roberto, Vassallo, Costantino, Zampaletta, Angelo, Zullo, Daniele, Piovani, Stefanos, Bonovas, Silvio, Danese, Paolo, Usai, Tursi, A., Brandimarte, G., Di Mario, F., Elisei, W., Picchio, M., Allegretta, L., Annunziata, M. L., Bafutto, M., Bassotti, G., Bianco, M. A., Colucci, R., Conigliaro, R., Dumitrascu, D., Escalante, R., Ferrini, L., Forti, G., Franceschi, M., Graziani, M. G., Lammert, F., Latella, G., Maconi, G., Nardone, G., Camara de Castro Oliveira, L., Chaves Oliveira, E., Papa, A., Papagrigoriadis, S., Pietrzak, A., Pontone, S., Poskus, T., Pranzo, G., Reichert, M. C., Rodino, S., Regula, J., Scaccianoce, G., Scaldaferri, F., Vassallo, R., Zampaletta, C., Zullo, A., Piovani, D., Bonovas, S., and Danese, S.

Subjects
medicine.medical_specialty, Prognosi, diverticular disease, Coda, Cohort Studies, Colonic, Internal medicine, Diverticulosis, Colonic, medicine, Humans, Prospective Studies, endoscopy, Prospective cohort study, Diverticuliti, Diverticulitis, Inflammation, Diverticular Diseases, Diverticulosis, medicine.diagnostic_test, business.industry, Colonoscopy, Prognosis, Diverticulum, Gastroenterology, medicine.disease, Endoscopy, Prospective Studie, Diverticular disease, Cohort Studie, business, Complication, Human, Cohort study
Abstract

ObjectiveTo investigate the predictive value of the Diverticular Inflammation and Complication Assessment (DICA) classification and to develop and validate a combined endoscopic-clinical score predicting clinical outcomes of diverticulosis, named Combined Overview on Diverticular Assessment (CODA).DesignA multicentre, prospective, international cohort study.Setting43 gastroenterology and endoscopy centres located in Europe and South America.Participants2215 patients (2198 completing the study) at the first diagnosis of diverticulosis/diverticular disease were enrolled. Patients were scored according to DICA classifications.InterventionsA 3-year follow-up was performed.Main outcome measuresTo predict the acute diverticulitis and the surgery according to DICA classification. Survival methods for censored observation were used to develop and validate a novel combined endoscopic-clinical score for predicting diverticulitis and surgery (CODA score).ResultsThe 3-year cumulative probability of diverticulitis and surgery was of 3.3% (95% CI 2.5% to 4.5%) in DICA 1, 11.6% (95% CI 9.2% to 14.5%) in DICA 2 and 22.0% (95% CI 17.2% to 28.0%) in DICA 3 (p10% and >2.5% in CODA C, respectively. The CODA score showed optimal discrimination capacity in predicting the risk of surgery in the development (c-statistic: 0.829; 95% CI 0.811 to 0.846) and validation cohort (c-statistic: 0.943; 95% CI 0.905 to 0.981).ConclusionsDICA classification has a significant role in predicting the risk of diverticulitis and surgery in patients with diverticulosis, which is significantly enhanced by the CODA score.Trial registration numberNCT02758860.

Published
2022

121. Global multi-stakeholder endorsement of the MAFLD definition

Author

Nahum Méndez-Sánchez, Elisabetta Bugianesi, Robert G Gish, Frank Lammert, Herbert Tilg, Mindie H Nguyen, Shiv K Sarin, Núria Fabrellas, Shira Zelber-Sagi, Jian-Gao Fan, Gamal Shiha, Giovanni Targher, Ming-Hua Zheng, Wah-Kheong Chan, Shlomo Vinker, Takumi Kawaguchi, Laurent Castera, Yusuf Yilmaz, Marko Korenjak, C Wendy Spearman, Mehmet Ungan, Melissa Palmer, Mortada El-Shabrawi, Hans-Juergen Gruss, Jean-François Dufour, Anil Dhawan, Heiner Wedemeyer, Jacob George, Luca Valenti, Yasser Fouad, Manuel Romero‐Gomez, Mohammed Eslam, Maria Lorena Abate, Bahaa Abbas, Ahmed Amr Abbassy, Waleed Abd El Ghany, Amira Abd Elkhalek, Emad Abd ElMajeed, Mohammad Abdalgaber, Mohamed AbdAllah, Marwa Abdallah, Nourhan Abdallah, Shereen Abdelaleem, Yasser Abdelghani, Wael Abdelghany, Safaa Mohamed Abdelhalim, Wafaa Abdelhamid, Nehal Abdelhamid, Nadia A. Abdelkader, Elsayed Abdelkreem, Aly Mohamed Abdelmohsen, Awny Ali Abdelrahman, Sherief M Abd-elsalam, Doaa Abdeltawab, Abdulbaset Abduh, Nada Abdulhakam, Maheeba Abdulla, Navid Abedpoor, Ludovico Abenavoli, Fredrik Åberg, Omala Ablack, Mostafa Abo elftouh, Yousry Esam-Eldin Abo-Amer, Ashraf Aboubkr, Alaa Aboud, Amr M. Abouelnaga, Galal A. Aboufarrag, Ashraf Aboutaleb, Leticia Abundis, Gupse Adalı, Enrique Adames, Leon Adams, Danjuma Adda, Noor Adel, Nada Adel, Muhammad Adel Sayed, Taiba Jibril Afaa, Nawal Afredj, Gulnara Aghayeva, Alessio Aghemo, Carlos A. Aguilar-Salinas, Golo Ahlenstiel, Walid Ahmady, Wafaa Ahmed, Amira Ahmed, Samah Nasser Ahmed, Heba Mostafa Ahmed, Rasha Ahmed, Elmar Aigner, Mesut Akarsu, Maisam Akroush, Umit Akyuz, Mamun Al Mahtab, Tahani Al Qadiri, Yusriya Al Rawahi, Razzaq AL rubaee, Muna Al Saffar, Shahinul Alam, Zaid Al-Ani, Agustín Albillos, Mohamed Alboraie, Said Al-Busafi, Mohamed Al-Emam, Jawaher Alharthi, Kareem Ali, Basma Abdelmoez Ali, Mohammad Ali, Raja Affendi Raja Ali, Anna Alisi, Ali Raad AL-Khafaji, Maryam Alkhatry, Rocio Aller, Yahya Almansoury, Khalid Al-Naamani, Alaa Alnakeeb, Anna Alonso, Saleh A. Alqahtani, Leina Alrabadi, Khalid Alswat, Mahir Altaher, Turki Altamimi, Jose Altamirano, Mario R. Alvares-da-Silva, Elsragy Adel M. Aly, Amgad Alzahaby, Ahmed Alzamzamy, Keisuke Amano, Maysa A. Amer, Mona A. Amin, Sayed A. Amin, Ashraf A. Amir, Javier Ampuero, Noha Anas, Pietro Andreone, Soa Fy Andriamandimby, Mahmoud Anees, Peltec Angela, Manal Antonios, Wael Arafat, Jose Moreno Araya, Juan Armendariz-Borunda, Matthew J. Armstrong, Hassan Ashktorab, Patricia Aspichueta, Fathia Assal, Mira Atef, Dina Attia, Hoda Atwa, Reham Awad, Mohyeldeen Abd Elaziz Awad, Sally Awny, Obafemi Awolowo, Yaw Asante Awuku, Ibrahim Ayada, Than Than Aye, Sherif Ayman, Hedy Ayman, Hesham Ayoub, Hosny M. Azmy, Romiro P. Babaran, Omneya Badreldin, Ahmed Badry, İbrahim Halil Bahçecioğlu, Amira Bahour, Jiajia Bai, Yasemin Balaban, Muthuswamy Balasubramanyam, Khaled Bamakhrama, Jesus M Banales, Babu Bangaru, Jianfeng Bao, Jorge Suazo Barahona, Salma Barakat, Sandra Maria Barbalho, Bikwa Barbra, Beatriz Barranco, Francisco Barrera, Ulrich Baumann, Shamardan Bazeed, Eva Bech, Aourarh Benayad, Andreas Benesic, David Bernstein, Fernando Bessone, Susie Birney, Cyrille Bisseye, Martin Blake, Bilal Bobat, Leonilde Bonfrate, Dmitry S Bordin, Francisco Bosques-Padilla, Jerome Boursier, Boushab Mohamed Boushab, David Bowen, Patricia Medina Bravo, Paul N Brennan, Bisi Bright, Ilse Broekaert, Xabier Buque, Diego Burgos-Santamaría, Julio Burman, Luca Busetto, Chris D. Byrne, Patricia Anne I. Cabral-Prodigalidad, Guillermo Cabrera-Alvarez, Wei Cai, Francesca Cainelli, Ali Riza Caliskan, Ali Canbay, Ana Cano-Contreras, Hai-Xia Cao, Zhujun Cao, Andres Carrion, Francesca Carubbi, Teresa Casanovas, Marlen Ivón Castellanos Fernández, Jin Chai, Siew Pheng Chan, Phunchai Charatcharoenwitthaya, Norberto Chavez-Tapia, Kazuaki Chayama, Jinjun Chen, Lin Chen, Zhong-Wei Chen, Huiting Chen, Sui-Dan Chen, Qiang Chen, Yaxi Chen, Gang Chen, En-Quang Chen, Fei Chen, Pei-Jer Chen, Robert Cheng, Wendy Cheng, Jack Tan Wei Chieh, Imad Chokr, Evangelos Cholongitas, Ashok Choudhury, Abhijit Chowdhury, Evaristus Sunday Chukwudike, Stefano Ciardullo, Michelle Clayton, Karine Clement, Marie Michelle Cloa, Cecilia Coccia, Cristina Collazos, Massimo Colombo, Arif Mansur Cosar, Helma Pinchemel Cotrim, Joris Couillerot, Alioune Coulibaly, Gonzalo Crespo, Javier Crespo, Maria Cruells, Ian Homer Y. Cua, Hesham K. Dabbous, George N Dalekos, Patricia D'Alia, Li Dan, Viet Hang Dao, Mostafa Darwish, Christian Datz, Milagros B Davalos-Moscol, Heba Dawoud, Blanca Olaechea de Careaga, Robert de Knegt, Victor de Ledinghen, Janaka de Silva, Nabil Debzi, Marie Decraecker, Elvira Del Pozo, Teresa C Delgado, Manuel Delgado-Blanco, Łukasz Dembiński, Adilson Depina, Moutaz Derbala, Hailemichael Desalegn, Christèle Desbois-Mouthon, Mahmoud Desoky, Anouk Dev, Agostino Di Ciaula, Moisés Diago, Ibrahima Diallo, Luis Antonio Díaz, Melisa Dirchwolf, Paola Dongiovanni, Andrriy Dorofeyev, Xiaoguang Dou, Mark W. Douglas, Michael Doulberis, Cecil K. Dovia, Adam Doyle, Ivana Dragojević, Joost PH Drenth, Xuefei Duan, Audrius Dulskas, Dan L Dumitrascu, Oliver Duncan, Vincent Dusabejambo, Rev. Shem N.A. Dwawhi, Sho Eiketsu, Doaa El Amrousy, Ahmed El Deeb, Ghada El Deriny, Hesham Salah El Din, Salwa El Kamshishy, Mohamed El Kassas, Maissa El Raziky, Osama A Elagamy, Wafaa Elakel, Dina Elalfy, Hanaa Elaraby, Heba ElAwady, Reda Elbadawy, Hanaa Hassan Eldash, Manal S. Eldefrawy, Carol Lezama Elecharri, Amel Elfaramawy, Mohammed Elfatih, Mahmoud Elfiky, Mohamed Elgamsy, Mohamed Elgendy, Mohamed A. El-Guindi, Nagi Elhussieny, Ahmed Maher Eliwa, Zeineb Elkabbany, Hesham El-Khayat, Nehal M. El-Koofy, Alaa Elmetwalli, Amr Elrabat, Fathiya El-Raey, Fatma Elrashdy, Medhat Elsahhar, Esraa M. Elsaid, Shimaa Elsayed, Hany Elsayed, Aly Elsayed, Amr M. Elsayed, Hamdy Elsayed, Magdy El-Serafy, Ahmed M. Elsharkawy, Reem Yehia Elsheemy, Eman Elsayed Elshemy, Sara Elsherbini, Naglaa Eltoukhy, Reda Elwakil, Ola Emad, Shaimaa Emad, Mohamed Embabi, Ilkay Ergenç, Tatiana Ermolova, Gamal Esmat, Doaa M. Esmat, Enrique Carrera Estupiñan, Said Ettair, Tcaciuc Eugen, Mohammed Ezz-Eldin, Lidia Patricia Valdivieso Falcón, Yu-Chen Fan, Samah Fandari, Mahmoud Farag, Taghreed Mohamed Farahat, Eman M. Fares, Michael Fares, Eduardo Fassio, Hayam Fathy, Dina Fathy, Wael Fathy, Soheir Fayed, Dan Feng, Gong Feng, Miguel Fernández-Bermejo, Cristina Targa Ferreira, Javier Díaz Ferrer, Alastair Forbes, Rabab Fouad, Hanan M. Fouad, Tove Frisch, Hideki Fujii, Shuhei Fukunaga, Shinya Fukunishi, Hacer Fulya, Masato Furuhashi, Yasmine Gaber, Augusto Jose G. Galang, Jacqueline Cordova Gallardo, Rocío Galloso, Mahmoud Gamal, Reham Gamal, Hadeel Gamal, Jian Gan, Anar Ganbold, Xin Gao, George Garas, Tony Garba, Miren García-Cortes, Carmelo García-Monzón, Javier García-Samaniego, Amalia Gastaldelli, Manuel Gatica, Elizabeth Gatley, Tamar Gegeshidze, Bin Geng, Hasmik Ghazinyan, Salma Ghoneem, Luca Giacomelli, Gianluigi Giannelli, Edoardo G. Giannini, Matthew Giefer, Pere Ginès, Marcos Girala, Pablo J Giraudi, George Boon-Bee Goh, Ahmed Ali Gomaa, Benbingdi Gong, Dina Hilda C. Gonzales, Humberto C. Gonzalez, Maria Saraí Gonzalez-Huezo, Isabel Graupera, Ivica Grgurevic, Henning Grønbæk, Xuelian Gu, Lin Guan, Ibrahima Gueye, Alice Nanelin Guingané, Ozen Oz Gul, Cuma Bulent Gul, Qing Guo, Pramendra Prasad Gupta, Ahmet Gurakar, Juan Carlos Restrepo Gutierrez, Ghada Habib, Azaa Hafez, Emilia Hagman, Eman Halawa, Osama Hamdy, Abd Elkhalek Hamed, Dina H. Hamed, Saeed Hamid, Waseem Hamoudi, Yu Han, James Haridy, Hanan Haridy, David C H Harris Harris, Michael Hart, Fuad Hasan, Almoutaz Hashim, Israa Hassan, Ayman Hassan, Essam Ali Hassan, Adel Ahmed Hassan, Magda Shehata Hassan, Fetouh Hassanin, Alshymaa Hassnine, John Willy Haukeland, Amr Ismael M. Hawal, Jinfan He, Qiong He, Yong He, Fang-Ping He, Mona Hegazy, Adham Hegazy, Osama Henegil, Nelia Hernández, Manuel Hernández-Guerra, Fatima Higuera-de-la-Tijera, Ibrahim Hindy, Keisuke Hirota, Lee Chi Ho, Alexander Hodge, Mohamed Hosny, Xin Hou, Jiao-Feng Huang, Yan Huang, Zhifeng Huang, Yuan Huang, Ang Huang, Xiao-Ping Huang, Sheng Hui-ping, Bela Hunyady, Mennatallah A. Hussein, Osama Hussein, Shahinaz Mahmoud Hussien, Luis Ibáñez-Samaniego, Jamal Ibdah, Luqman Ibrahim, Miada Ibrahim, Ibrahim Ibrahim, Maria E. Icaza-Chávez, Sahar Idelbi, Ramazan Idilman Idilman, Mayumi Ikeda, Giuseppe Indolfi, Federica Invernizzi, Iram Irshad, Hasan Mohamed Ali Isa, Natacha Jreige Iskandar, Abdulrahman Ismaiel, Mariam Ismail, Zulkifli Ismail, Faisal Ismail, Hideki Iwamoto, Kathryn Jack, Rachael Jacob, Fuad Jafarov, Wasim Jafri, Helen Jahshan, Prasun K Jalal, Ligita Jancoriene, Martin Janicko, Hiruni Jayasena, Meryem Jefferies, Vivekanand Jha, Fanpu Ji, Yaqiu Ji, Jidong Jia, Changtao Jiang, Ni Jiang, Zong-zhe Jiang, Xing Jin, Yi Jin, Xu Jing, Qian Jingyu, Maia Jinjolava, FX Himawan Haryanto Jong, Alina Jucov, Ibecheole Julius, Mona Kaddah, Yoshihiro Kamada, Abobakr kamal, Enas Mohamed Kamal, Ashraf Sayed Kamel, Jia-Horng Kao, Maja Karin, Thomas Karlas, Mohammad Kashwaa, Leolin Katsidzira, Eda Kaya, M.Azzam Kayasseh, Bernadette Keenan, Caglayan Keklikkiran, William Keml, Deia K. Khalaf, Rofida Khalefa, Sherin Khamis, Doaa Khater, Hamed khattab, Anatoly Khavkin, Olga Khlynova, Nabil Khmis, Nazarii Kobyliak, Apostolos Koffas, Kazuhiko Koike, Kenneth Y.Y. Kok, Tomas Koller, Narcisse Patrice Komas, Nataliya V. Korochanskaya, Yannoula Koulla, Shunji Koya, Colleen Kraft, Bledar Kraja, Marcin Krawczyk, Mohammad Shafi Kuchay, Anand V Kulkarni, Ashish Kumar, Manoj Kumar, Sulaiman Lakoh, Philip Lam, Ling Lan, Naomi F. Lange, Kamran Bagheri Lankarani, Nicolas Lanthier, Kateryna Lapshyna, Sameh A. Lashen, Konang Nguieguia Justine Laure, Leonid Lazebnik, Didier Lebrec, Samuel S. Lee, Way Seah Lee, Yeong Yeh Lee, Diana Julie Leeming, Nathalie Carvalho Leite, Roberto Leon, Cosmas Rinaldi Adithya Lesmana, Junfeng Li, Qiong Li, Jun Li, Yang-Yang Li, Yufang Li, Lei Li, Min Li, Yiling li, Huiqing Liang, Tang Lijuan, Seng Gee Lim, Lee-Ling Lim, Shumei Lin, Han-Chieh Lin, Rita Lin, Rania Lithy, Yaru Liu, Yuanyuan Liu, Xin Liu, Wen-Yue Liu, Shourong Liu, Ken Liu, Tian Liu, Amedeo Lonardo, Mariana Bravo López, Eva López-Benages, Patricio Lopez-Jaramillo, Huimin Lu, Lun Gen Lu, Yan Lu, John Lubel, Rashid Lui, Iulianna Lupasco, Elena Luzina, Xiao-Hui Lv, Kate Lynch, Hong-Lei Ma, Mariana Verdelho Machado, Nonso Maduka, Katerina Madzharova, Russellini Magdaong, Sanjiv Mahadeva, Amel Mahfouz, Nik Ritza Kosai Nik Mahmood, Eman Mahmoud, Mohamed Mahrous, Rakhi Maiwall, Ammar Majeed, Avik Majumdar, Loey Mak, Madiha M Maklouf, Reza Malekzadeh, Claudia Mandato, Alessandra Mangia, Jake Mann, Hala Hussien Mansour, Abdellah Mansouri, Alessandro Mantovani, Jun qian Mao, Flor Maramag, Giulio Marchesini, Claude Marcus, Rui António Rocha Tato Marinho, Maria L Martinez-Chantar, Antonieta A. Soares Martins, Rana Marwan, Karen Frances Mason, Ghadeer Masoud, Mohamed Naguib Massoud, Maria Amalia Matamoros, Rosa Martín Mateos, Asmaa Mawed, Jean Claude Mbanya, Charles Mbendi, Lone McColaugh, Duncan McLeod, Juan Francisco Rivera Medina, Ahmed Megahed, Mai Mehrez, Iqbal Memon, Shahin Merat, Randy Mercado, Ahmed Mesbah, Taoufik Meskini, Mayada Metwally, Rasha Metwaly, Lei Miao, Eileen Micah, Luca Miele, Vladimir Milivojevic, Tamara Milovanovic, Yvonne L. Mina, Milan Mishkovik, Amal Mishriki, Tim Mitchell, Alshaimaa Mohamed, Mona Mohamed, Sofain Mohamed, Shady Mohammed, Ahmed Mohammed, Viswanathan Mohan, Sara Mohie, Aalaa Mokhtar, Reham Moniem, Mabel Segura Montilla, Jose Antonio Orozco Morales, María María Sánchez Morata, Jose Maria Moreno-Planas, Silvia Morise, Sherif Mosaad, Mohamed Moselhy, Alaa Mohamed Mostafa, Ebraheem Mostafa, Nezha Mouane, Nasser Mousa, Hamdy Mahfouz Moustafa, Abeer Msherif, Kate Muller, Christopher Munoz, Ana Beatriz Muñoz-Urribarri, Omar Alfaro Murillo, Feisul Idzwan Mustapha, Emir Muzurović, Yehia Nabil, Shaymaa Nafady, Ayu Nagamatsu, Atsushi Nakajima, Dan Nakano, Yuemin Nan, Fabio Nascimbeni, Mirella S. Naseef, Nagwa Nashat, Taran Natalia, Francesco Negro, Alexander V. Nersesov, Manuela Neuman, Masolwa Ng'wanasayi, Yan Ni, Amanda Nicoll, Takashi Niizeki, Dafina Nikolova, Wang Ningning, Madunil Niriella, K.A Nogoibaeva, Rozeena Nordien, Catherine O Sullivan, James O'Beirne, Solomon Obekpa, Ponsiano Ocama, Missiani Ochwoto, Michael Promise Ogolodom, Olusegun Ojo, Nana Okrostsvaridze, Claudia P. Oliveira, Raul Contreras Omaña, Omneya M. Omar, Hanaa Omar, Mabroka Omar, Salma Omran, Reham Omran, Marian Muse Osman, Nevin Owise, Theobald Owusu-Ansah, P. Martín Padilla- Machaca, Sirish Palle, Ziyan Pan, Xiao-Yan Pan, Qiuwei Pan, Apostolis Papaefthymiou, Feliciano Chanana Paquissi, Gabriella Par, Arit Parkash, Diana Payawal, Kevork M. Peltekian, Xuebin Peng, Liang Peng, Ying Peng, Rahul Pengoria, Martina Perez, José Luis Pérez, Norma Marlene Pérez, Marcello Persico, Mário Guimarães Pessoa, Salvatore Petta, Mathew Philip, Maria Corina Plaz Torres, Naveen Polavarapu, Jaime Poniachik, Piero Portincasa, Chunwen Pu, Tuğrul Pürnak, Edhie Purwanto, Xiaolong Qi, Xingshun Qi, Zibing Qian, Zhao Qiang, Zengpei Qiao, Liang Qiao, Alberto Queiroz, Atoosa Rabiee, Manal Radwan, Alain Marcel Rahetilahy, Yasmin Ramadan, Dina Ramadan, Anis Safura Ramli, Grant A. Ramm, Ao Ran, Ivan Rankovic, Huiying RAO, Sara Raouf, Sayantan Ray, Nancy Reau, Ahmed Refaat, Thomas Reiberger, Jose M Remes-Troche, Eira Cerda Reyes, Ben Richardson, Ezequiel Ridruejo, Sergio Riestra Jimenez, Ibrahim Rizk, Stuart Roberts, Juan Pablo Roblero, Jorge Alberto Prado Robles, Don Rockey, Manuel Rodríguez, Heriberto Rodríguez Hernández, Eva Román, Fernando Gomes Romeiro, Stefano Romeo, Jose Miguel Rosales-Zabal, Georgina R. Roshdi, Natalia Rosso, Andres Ruf, Patricia Cordero Ruiz, Nelia R. Runes, Andrea Ruzzenente, Marno Ryan, Ahmed Saad, Eman BE Sabbagh, Meriam Sabbah, Shimaa Saber, Reham Sabrey, Ramy Sabry, Maysaa Abdallah Saeed, Dina Said, Ebada M Said, Mohammad Amin Sakr, Yara Salah, Rabab Maamoun Salama, Asmaa Salama, Hussein Saleh, Ahmed Saleh, Ahmed Salem, Ahmed Thabet Salem, Alkassoum Salifou, Aso Faeq Salih, Abdallah Salman, Hanen Samouda, Faisal Sanai, Juan Francisco Sánchez-Ávila, Lakshumanan Sanker, Tomoya Sano, Miquel Sanz, Tobokalova Saparbu, Rohit Sawhney, Fatma Sayed, Sayed A. Sayed, Ashraf Othman Sayed, Manar Sayed, Giada Sebastiani, Laura Secadas, Khawaja Qamaruddin Sediqi, Sameh Seif, Nady Semida, Ebubekir Şenateş, Elena Daniela Serban, Lawrence Serfaty, Wai-Kay Seto, Ikram Sghaier, Min Sha, Hamada M. Shabaan, Lobna Shalaby, Inass Shaltout, Ala I. Sharara, Vishal Sharma, Isaac Thom Shawa, Ahmed Shawkat, Nehal Shawky, Osama Shehata, Sinead Sheils, Abate Bane Shewaye, Guojun Shi, Junping Shi, Shigeo Shimose, Tomotake Shirono, Lan Shou, Ananta Shrestha, Guanghou Shui, William Sievert, Solveig Sigurdardottir, Mostafa Mohamed Sira, Riyadh Siradj, Cecilia Sison, Linda Smyth, Reham Soliman, Jose D Sollano, Roger Sombie, Mark Sonderup, Siddharth Sood, German Soriano, Catherine A M Stedman, Oksana Stefanyuk, Davor Štimac, Simone Strasser, Pavel Strnad, Katherine Stuart, Wen Su, Minghua Su, Yoshio Sumida, Shuji Sumie, Dan-Qin Sun, Jing Sun, Hiroyuki Suzuki, Gianluca Svegliati-Baroni, Mohamed Osman Swar, S. TAHARBOUCHT, Zenab Taher, Saori Takamura, Lin Tan, Soek-Siam Tan, Tawesak Tanwandee, Sara Tarek, Ghelimici Tatiana, Federica Tavaglione, Gina Y. Tecson, Hoi-Poh Tee, Rolf Teschke, Mostafa Tharwat, Vo Duy Thong, Mark Thursz, Tulari Tine, Claudio Tiribelli, Ieva Tolmane, Jing Tong, Marco Tongo, Mamdouh Torkie, Aldo Torre, Esther A Torres, Meri Trajkovska, Sombat Treeprasertsuk, Tsubasa Tsutsumi, Thomas Tu, Josep A. Tur, Dilara Turan, Svetlana Turcan, Svetlana Turkina, Engin Tutar, Christian Tzeuton, Rose Ugiagbe, Ahmet Uygun, Michele Vacca, Pietro Vajro, David Van der Poorten, Laurens A. Van Kleef, Eliza Vashakidze, Carlos Moctezuma Velazquez, Mirtha Infante Velazquez, Sandro Vento, Veronique Verhoeven, Umberto Vespasiani-Gentilucci, Shireene Ratna Vethakkan, Josep Vilaseca, Libor Vítek, Ance Volkanovska, Michael Wallace, Wang Wan, Yan Wang, Ying Wang, Xiaolin Wang, Xuemei Wang, Chengyan Wang, Chunjiong Wang, Mingjie Wang, Pelden Wangchuk, Martin Weltman, MaryFrances White, Johannes Wiegand, Mohamed-Naguib Wifi, Alan Wigg, Markus Wilhelmi, Remon William, Henning Wittenburg, Shengjie Wu, Abdu Mohammed Wubeneh, Hongping Xia, Jian Xiao, Xiao Xiao, Wang Xiaofeng, Wanyuan Xiong, Liang Xu, Jie Xu, Weiguo Xu, Jing-Hang Xu, Keshu Xu, Yumin Xu, Shi-Hao Xu, Meng Xu, Aimin Xu, Chengfu Xu, Hongmei Yan, Jingyi Yang, Rui-Xu Yang, Yating Yang, Qinhe Yang, Naibin Yang, Jia Yao, Justine Yara, Serkan Yaraş, Nimet Yılmaz, Ramy Younes, Huda younes, Sona Young, Farah Youssef, Yanyan Yu, Ming-Lung Yu, Jing Yuan, Zhang Yue, Man-Fung Yuen, Wang Yun, Nonka Yurukova, Serag Zakaria, Samy Zaky, Maia Zaldastanishvili, Rodrigo Zapata, Nazanin Zare, Enver Zerem, Nema Zeriban, Xu Zeshuai, Huijie Zhang, Xuemei Zhang, Yupei Zhang, Wen-Hua Zhang, Xuchen Zhang, Yon-ping Zhang, Yuexin Zhang, Zhan-qing Zhang, Jingmin Zhao, Rong-Rong Zhao, Hongwei Zhao, Chao Zheng, Yijie Zheng, Ruidan Zheng, Tian-Lei Zheng, Kenneth Zheng, Xi Qiao Zhou, Yongjian Zhou, Yu-Jie Zhou, Hong Zhou, Ling Zhou, Yongning Zhou, Long dong Zhu, Yong Fen Zhu, Yueyong Zhu, Pei-Wu Zhu, Ebtesam Ziada, David Ziring, Li Ziyi, Shanshan Zou, Zhengsheng Zou, Huaibin Zou, Roberto Zuart Ruiz, UCL - (SLuc) Service de gastro-entérologie, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Mendez-Sanchez, N, Bugianesi, E, Gish, R, Lammert, F, Tilg, H, Nguyen, M, Sarin, S, Fabrellas, N, Zelber-Sagi, S, Fan, J, Shiha, G, Targher, G, Zheng, M, Chan, W, Vinker, S, Kawaguchi, T, Castera, L, Yilmaz, Y, Korenjak, M, Spearman, C, Ungan, M, Palmer, M, El-Shabrawi, M, Gruss, H, Dufour, J, Dhawan, A, Wedemeyer, H, George, J, Valenti, L, Fouad, Y, Romero-Gomez, M, Eslam, M, Abate, M, Abbas, B, Abbassy, A, Abd El Ghany, W, Abd Elkhalek, A, Abd ElMajeed, E, Abdalgaber, M, Abdallah, M, Abdallah, N, Abdelaleem, S, Abdelghani, Y, Abdelghany, W, Abdelhalim, S, Abdelhamid, W, Abdelhamid, N, Abdelkader, N, Abdelkreem, E, Abdelmohsen, A, Abdelrahman, A, Abd-elsalam, S, Abdeltawab, D, Abduh, A, Abdulhakam, N, Abdulla, M, Abedpoor, N, Abenavoli, L, Aberg, F, Ablack, O, Abo elftouh, M, Abo-Amer, Y, Aboubkr, A, Aboud, A, Abouelnaga, A, Aboufarrag, G, Aboutaleb, A, Abundis, L, Adali, G, Adames, E, Adams, L, Adda, D, Adel, N, Adel Sayed, M, Afaa, T, Afredj, N, Aghayeva, G, Aghemo, A, Aguilar-Salinas, C, Ahlenstiel, G, Ahmady, W, Ahmed, W, Ahmed, A, Ahmed, S, Ahmed, H, Ahmed, R, Aigner, E, Akarsu, M, Akroush, M, Akyuz, U, Al Mahtab, M, Al Qadiri, T, Al Rawahi, Y, AL rubaee, R, Al Saffar, M, Alam, S, Al-Ani, Z, Albillos, A, Alboraie, M, Al-Busafi, S, Al-Emam, M, Alharthi, J, Ali, K, Ali, B, Ali, M, Ali, R, Alisi, A, AL-Khafaji, A, Alkhatry, M, Aller, R, Almansoury, Y, Al-Naamani, K, Alnakeeb, A, Alonso, A, Alqahtani, S, Alrabadi, L, Alswat, K, Altaher, M, Altamimi, T, Altamirano, J, Alvares-da-Silva, M, Aly, E, Alzahaby, A, Alzamzamy, A, Amano, K, Amer, M, Amin, M, Amin, S, Amir, A, Ampuero, J, Anas, N, Andreone, P, Andriamandimby, S, Anees, M, Angela, P, Antonios, M, Arafat, W, Araya, J, Armendariz-Borunda, J, Armstrong, M, Ashktorab, H, Aspichueta, P, Assal, F, Atef, M, Attia, D, Atwa, H, Awad, R, Awad, M, Awny, S, Awolowo, O, Awuku, Y, Ayada, I, Aye, T, Ayman, S, Ayman, H, Ayoub, H, Azmy, H, Babaran, R, Badreldin, O, Badry, A, Bahcecioglu, I, Bahour, A, Bai, J, Balaban, Y, Balasubramanyam, M, Bamakhrama, K, Banales, J, Bangaru, B, Bao, J, Barahona, J, Barakat, S, Barbalho, S, Barbra, B, Barranco, B, Barrera, F, Baumann, U, Bazeed, S, Bech, E, Benayad, A, Benesic, A, Bernstein, D, Bessone, F, Birney, S, Bisseye, C, Blake, M, Bobat, B, Bonfrate, L, Bordin, D, Bosques-Padilla, F, Boursier, J, Boushab, B, Bowen, D, Bravo, P, Brennan, P, Bright, B, Broekaert, I, Buque, X, Burgos-Santamaria, D, Burman, J, Busetto, L, Byrne, C, Cabral-Prodigalidad, P, Cabrera-Alvarez, G, Cai, W, Cainelli, F, Caliskan, A, Canbay, A, Cano-Contreras, A, Cao, H, Cao, Z, Carrion, A, Carubbi, F, Casanovas, T, Castellanos Fernandez, M, Chai, J, Chan, S, Charatcharoenwitthaya, P, Chavez-Tapia, N, Chayama, K, Chen, J, Chen, L, Chen, Z, Chen, H, Chen, S, Chen, Q, Chen, Y, Chen, G, Chen, E, Chen, F, Chen, P, Cheng, R, Cheng, W, Chieh, J, Chokr, I, Cholongitas, E, Choudhury, A, Chowdhury, A, Chukwudike, E, Ciardullo, S, Clayton, M, Clement, K, Cloa, M, Coccia, C, Collazos, C, Colombo, M, Cosar, A, Cotrim, H, Couillerot, J, Coulibaly, A, Crespo, G, Crespo, J, Cruells, M, Cua, I, Dabbous, H, Dalekos, G, D'Alia, P, Dan, L, Dao, V, Darwish, M, Datz, C, Davalos-Moscol, M, Dawoud, H, de Careaga, B, de Knegt, R, de Ledinghen, V, de Silva, J, Debzi, N, Decraecker, M, Del Pozo, E, Delgado, T, Delgado-Blanco, M, Dembinski, L, Depina, A, Derbala, M, Desalegn, H, Desbois-Mouthon, C, Desoky, M, Dev, A, Di Ciaula, A, Diago, M, Diallo, I, Diaz, L, Dirchwolf, M, Dongiovanni, P, Dorofeyev, A, Dou, X, Douglas, M, Doulberis, M, Dovia, C, Doyle, A, Dragojevic, I, Drenth, J, Duan, X, Dulskas, A, Dumitrascu, D, Duncan, O, Dusabejambo, V, Dwawhi, R, Eiketsu, S, El Amrousy, D, El Deeb, A, El Deriny, G, El Din, H, El Kamshishy, S, El Kassas, M, El Raziky, M, Elagamy, O, Elakel, W, Elalfy, D, Elaraby, H, Elawady, H, Elbadawy, R, Eldash, H, Eldefrawy, M, Elecharri, C, Elfaramawy, A, Elfatih, M, Elfiky, M, Elgamsy, M, Elgendy, M, El-Guindi, M, Elhussieny, N, Eliwa, A, Elkabbany, Z, El-Khayat, H, El-Koofy, N, Elmetwalli, A, Elrabat, A, El-Raey, F, Elrashdy, F, Elsahhar, M, Elsaid, E, Elsayed, S, Elsayed, H, Elsayed, A, El-Serafy, M, Elsharkawy, A, Elsheemy, R, Elshemy, E, Elsherbini, S, Eltoukhy, N, Elwakil, R, Emad, O, Emad, S, Embabi, M, Ergenc, I, Ermolova, T, Esmat, G, Esmat, D, Estupinan, E, Ettair, S, Eugen, T, Ezz-Eldin, M, Falcon, L, Fan, Y, Fandari, S, Farag, M, Farahat, T, Fares, E, Fares, M, Fassio, E, Fathy, H, Fathy, D, Fathy, W, Fayed, S, Feng, D, Feng, G, Fernandez-Bermejo, M, Ferreira, C, Ferrer, J, Forbes, A, Fouad, R, Fouad, H, Frisch, T, Fujii, H, Fukunaga, S, Fukunishi, S, Fulya, H, Furuhashi, M, Gaber, Y, Galang, A, Gallardo, J, Galloso, R, Gamal, M, Gamal, R, Gamal, H, Gan, J, Ganbold, A, Gao, X, Garas, G, Garba, T, Garcia-Cortes, M, Garcia-Monzon, C, Garcia-Samaniego, J, Gastaldelli, A, Gatica, M, Gatley, E, Gegeshidze, T, Geng, B, Ghazinyan, H, Ghoneem, S, Giacomelli, L, Giannelli, G, Giannini, E, Giefer, M, Gines, P, Girala, M, Giraudi, P, Goh, G, Gomaa, A, Gong, B, Gonzales, D, Gonzalez, H, Gonzalez-Huezo, M, Graupera, I, Grgurevic, I, Gronbaek, H, Gu, X, Guan, L, Gueye, I, Guingane, A, Gul, O, Gul, C, Guo, Q, Gupta, P, Gurakar, A, Gutierrez, J, Habib, G, Hafez, A, Hagman, E, Halawa, E, Hamdy, O, Hamed, A, Hamed, D, Hamid, S, Hamoudi, W, Han, Y, Haridy, J, Haridy, H, Harris, D, Hart, M, Hasan, F, Hashim, A, Hassan, I, Hassan, A, Hassan, E, Hassan, M, Hassanin, F, Hassnine, A, Haukeland, J, Hawal, A, He, J, He, Q, He, Y, He, F, Hegazy, M, Hegazy, A, Henegil, O, Hernandez, N, Hernandez-Guerra, M, Higuera-de-la-Tijera, F, Hindy, I, Hirota, K, Ho, L, Hodge, A, Hosny, M, Hou, X, Huang, J, Huang, Y, Huang, Z, Huang, A, Huang, X, Hui-ping, S, Hunyady, B, Hussein, M, Hussein, O, Hussien, S, Ibanez-Samaniego, L, Ibdah, J, Ibrahim, L, Ibrahim, M, Ibrahim, I, Icaza-Chavez, M, Idelbi, S, Idilman, R, Ikeda, M, Indolfi, G, Invernizzi, F, Irshad, I, Isa, H, Iskandar, N, Ismaiel, A, Ismail, M, Ismail, Z, Ismail, F, Iwamoto, H, Jack, K, Jacob, R, Jafarov, F, Jafri, W, Jahshan, H, Jalal, P, Jancoriene, L, Janicko, M, Jayasena, H, Jefferies, M, Jha, V, Ji, F, Ji, Y, Jia, J, Jiang, C, Jiang, N, Jiang, Z, Jin, X, Jin, Y, Jing, X, Jingyu, Q, Jinjolava, M, Jong, F, Jucov, A, Julius, I, Kaddah, M, Kamada, Y, Kamal, A, Kamal, E, Kamel, A, Kao, J, Karin, M, Karlas, T, Kashwaa, M, Katsidzira, L, Kaya, E, Kayasseh, M, Keenan, B, Keklikkiran, C, Keml, W, Khalaf, D, Khalefa, R, Khamis, S, Khater, D, Khattab, H, Khavkin, A, Khlynova, O, Khmis, N, Kobyliak, N, Koffas, A, Koike, K, Kok, K, Koller, T, Komas, N, Korochanskaya, N, Koulla, Y, Koya, S, Kraft, C, Kraja, B, Krawczyk, M, Kuchay, M, Kulkarni, A, Kumar, A, Kumar, M, Lakoh, S, Lam, P, Lan, L, Lange, N, Lankarani, K, Lanthier, N, Lapshyna, K, Lashen, S, Laure, K, Lazebnik, L, Lebrec, D, Lee, S, Lee, W, Lee, Y, Leeming, D, Leite, N, Leon, R, Lesmana, C, Li, J, Li, Q, Li, Y, Li, L, Li, M, Liang, H, Lijuan, T, Lim, S, Lim, L, Lin, S, Lin, H, Lin, R, Lithy, R, Liu, Y, Liu, X, Liu, W, Liu, S, Liu, K, Liu, T, Lonardo, A, Lopez, M, Lopez-Benages, E, Lopez-Jaramillo, P, Lu, H, Lu, L, Lu, Y, Lubel, J, Lui, R, Lupasco, I, Luzina, E, Lv, X, Lynch, K, Ma, H, Machado, M, Maduka, N, Madzharova, K, Magdaong, R, Mahadeva, S, Mahfouz, A, Mahmood, N, Mahmoud, E, Mahrous, M, Maiwall, R, Majeed, A, Majumdar, A, Mak, L, Maklouf, M, Malekzadeh, R, Mandato, C, Mangia, A, Mann, J, Mansour, H, Mansouri, A, Mantovani, A, Mao, J, Maramag, F, Marchesini, G, Marcus, C, Marinho, R, Martinez-Chantar, M, Martins, A, Marwan, R, Mason, K, Masoud, G, Massoud, M, Matamoros, M, Mateos, R, Mawed, A, Mbanya, J, Mbendi, C, Mccolaugh, L, Mcleod, D, Medina, J, Megahed, A, Mehrez, M, Memon, I, Merat, S, Mercado, R, Mesbah, A, Meskini, T, Metwally, M, Metwaly, R, Miao, L, Micah, E, Miele, L, Milivojevic, V, Milovanovic, T, Mina, Y, Mishkovik, M, Mishriki, A, Mitchell, T, Mohamed, A, Mohamed, M, Mohamed, S, Mohammed, S, Mohammed, A, Mohan, V, Mohie, S, Mokhtar, A, Moniem, R, Montilla, M, Morales, J, Morata, M, Moreno-Planas, J, Morise, S, Mosaad, S, Moselhy, M, Mostafa, A, Mostafa, E, Mouane, N, Mousa, N, Moustafa, H, Msherif, A, Muller, K, Munoz, C, Munoz-Urribarri, A, Murillo, O, Mustapha, F, Muzurovic, E, Nabil, Y, Nafady, S, Nagamatsu, A, Nakajima, A, Nakano, D, Nan, Y, Nascimbeni, F, Naseef, M, Nashat, N, Natalia, T, Negro, F, Nersesov, A, Neuman, M, Ng'Wanasayi, M, Ni, Y, Nicoll, A, Niizeki, T, Nikolova, D, Ningning, W, Niriella, M, Nogoibaeva, K, Nordien, R, O Sullivan, C, O'Beirne, J, Obekpa, S, Ocama, P, Ochwoto, M, Ogolodom, M, Ojo, O, Okrostsvaridze, N, Oliveira, C, Omana, R, Omar, O, Omar, H, Omar, M, Omran, S, Omran, R, Osman, M, Owise, N, Owusu-Ansah, T, Padilla- Machaca, P, Palle, S, Pan, Z, Pan, X, Pan, Q, Papaefthymiou, A, Paquissi, F, Par, G, Parkash, A, Payawal, D, Peltekian, K, Peng, X, Peng, L, Peng, Y, Pengoria, R, Perez, M, Perez, J, Perez, N, Persico, M, Pessoa, M, Petta, S, Philip, M, Plaz Torres, M, Polavarapu, N, Poniachik, J, Portincasa, P, Pu, C, Purnak, T, Purwanto, E, Qi, X, Qian, Z, Qiang, Z, Qiao, Z, Qiao, L, Queiroz, A, Rabiee, A, Radwan, M, Rahetilahy, A, Ramadan, Y, Ramadan, D, Ramli, A, Ramm, G, Ran, A, Rankovic, I, Rao, H, Raouf, S, Ray, S, Reau, N, Refaat, A, Reiberger, T, Remes-Troche, J, Reyes, E, Richardson, B, Ridruejo, E, Riestra Jimenez, S, Rizk, I, Roberts, S, Roblero, J, Robles, J, Rockey, D, Rodriguez, M, Rodriguez Hernandez, H, Roman, E, Romeiro, F, Romeo, S, Rosales-Zabal, J, Roshdi, G, Rosso, N, Ruf, A, Ruiz, P, Runes, N, Ruzzenente, A, Ryan, M, Saad, A, Sabbagh, E, Sabbah, M, Saber, S, Sabrey, R, Sabry, R, Saeed, M, Said, D, Said, E, Sakr, M, Salah, Y, Salama, R, Salama, A, Saleh, H, Saleh, A, Salem, A, Salifou, A, Salih, A, Salman, A, Samouda, H, Sanai, F, Sanchez-Avila, J, Sanker, L, Sano, T, Sanz, M, Saparbu, T, Sawhney, R, Sayed, F, Sayed, S, Sayed, A, Sayed, M, Sebastiani, G, Secadas, L, Sediqi, K, Seif, S, Semida, N, Senates, E, Serban, E, Serfaty, L, Seto, W, Sghaier, I, Sha, M, Shabaan, H, Shalaby, L, Shaltout, I, Sharara, A, Sharma, V, Shawa, I, Shawkat, A, Shawky, N, Shehata, O, Sheils, S, Shewaye, A, Shi, G, Shi, J, Shimose, S, Shirono, T, Shou, L, Shrestha, A, Shui, G, Sievert, W, Sigurdardottir, S, Sira, M, Siradj, R, Sison, C, Smyth, L, Soliman, R, Sollano, J, Sombie, R, Sonderup, M, Sood, S, Soriano, G, Stedman, C, Stefanyuk, O, Stimac, D, Strasser, S, Strnad, P, Stuart, K, Su, W, Su, M, Sumida, Y, Sumie, S, Sun, D, Sun, J, Suzuki, H, Svegliati-Baroni, G, Swar, M, Taharboucht, S, Taher, Z, Takamura, S, Tan, L, Tan, S, Tanwandee, T, Tarek, S, Tatiana, G, Tavaglione, F, Tecson, G, Tee, H, Teschke, R, Tharwat, M, Thong, V, Thursz, M, Tine, T, Tiribelli, C, Tolmane, I, Tong, J, Tongo, M, Torkie, M, Torre, A, Torres, E, Trajkovska, M, Treeprasertsuk, S, Tsutsumi, T, Tu, T, Tur, J, Turan, D, Turcan, S, Turkina, S, Tutar, E, Tzeuton, C, Ugiagbe, R, Uygun, A, Vacca, M, Vajro, P, Van der Poorten, D, Van Kleef, L, Vashakidze, E, Velazquez, C, Velazquez, M, Vento, S, Verhoeven, V, Vespasiani-Gentilucci, U, Vethakkan, S, Vilaseca, J, Vitek, L, Volkanovska, A, Wallace, M, Wan, W, Wang, Y, Wang, X, Wang, C, Wang, M, Wangchuk, P, Weltman, M, White, M, Wiegand, J, Wifi, M, Wigg, A, Wilhelmi, M, William, R, Wittenburg, H, Wu, S, Wubeneh, A, Xia, H, Xiao, J, Xiao, X, Xiaofeng, W, Xiong, W, Xu, L, Xu, J, Xu, W, Xu, K, Xu, Y, Xu, S, Xu, M, Xu, A, Xu, C, Yan, H, Yang, J, Yang, R, Yang, Y, Yang, Q, Yang, N, Yao, J, Yara, J, Yaras, S, Yilmaz, N, Younes, R, Younes, H, Young, S, Youssef, F, Yu, Y, Yu, M, Yuan, J, Yue, Z, Yuen, M, Yun, W, Yurukova, N, Zakaria, S, Zaky, S, Zaldastanishvili, M, Zapata, R, Zare, N, Zerem, E, Zeriban, N, Zeshuai, X, Zhang, H, Zhang, X, Zhang, Y, Zhang, W, Zhang, Z, Zhao, J, Zhao, R, Zhao, H, Zheng, C, Zheng, Y, Zheng, R, Zheng, T, Zheng, K, Zhou, X, Zhou, Y, Zhou, H, Zhou, L, Zhu, L, Zhu, Y, Zhu, P, Ziada, E, Ziring, D, Ziyi, L, Zou, S, Zou, Z, Zou, H, Zuart Ruiz, R, and Global Multi-Stakeholder Consensus on the Redefinition of Fatty Liver Disease

Subjects
Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Hepatology, Non-alcoholic Fatty Liver Disease, NAFLD, consensu, Gastroenterology, MAFLD, definition, Humans, MAFLD, NAFLD, Human medicine
Abstract

Contains fulltext : 252162.pdf (Publisher’s version ) (Closed access)

Published
2022

123. S3-Leitlinie : Diagnostik und Therapie des hepatozellulären Karzinoms

Author

Sabrina, Voesch, Michael, Bitzer, Jörg, Albert, Peter, Bartenstein, Wolf, Bechstein, Susanne, Blödt, Thomas, Brunner, Frank, Dombrowski, Matthias, Evert, Markus, Follmann, Christian, La Fougère, Paul, Freudenberger, Andreas, Geier, Eleni, Gkika, Martin, Götz, Elke, Hammes, Thomas, Helmberger, Ralf-Thorsten, Hoffmann, Wolf-Peter, Hofmann, Peter, Huppert, Achim, Kautz, Gabi, Knötgen, Jürgen, Körber, David, Krug, Frank, Lammert, Hauke, Lang, Thomas, Langer, Philipp, Lenz, Andreas, Mahnken, Alexander, Meining, Oliver, Micke, Silvio, Nadalin, HuuPhuc, Nguyen, Johann, Ockenga, Karl-Jürgen, Oldhafer, Philipp, Paprottka, Kerstin, Paradies, Philippe, Pereira, Thorsten, Persigehl, Mathias, Plauth, Ruben, Plentz, Jürgen, Pohl, Jutta, Riemer, Peter, Reimer, Johanna, Ringwald, Ulrike, Ritterbusch, Elke, Roeb, Barbara, Schellhaas, Peter, Schirmacher, Irene, Schmid, Andreas, Schuler, Von Dietrich, Schweinitz, Daniel, Seehofer, Marianne, Sinn, Alexander, Stein, Andreas, Stengel, Nadine, Steubesand, Christian, Stoll, Andrea, Tannapfel, Anne, Taubert, Jörg, Trojan, Van Ingo, Thiel, Reina, Tholen, Arndt, Vogel, Thomas, Vogl, Hilke, Vorwerk, Frank, Wacker, Oliver, Waidmann, Heiner, Wedemeyer, Henning, Wege, Dane, Wildner, Christian, Wittekind, Marcus-Alexander, Wörns, Peter, Galle, Nisar, Malek, Huu Phuc, Nguyen, Dietrich, von Schweinitz, and Ingo, van Thiel

Subjects
Medizin
Published
2022

124. Genetics of Gallstone Disease

Author

Frank Lammert and Susanne N Weber

Subjects
Genetics, business.industry, Medicine, Disease, business
Published
2019

125. Unspecific CTL Killing Is Enhanced by High Glucose

Author

Wenjuan, Yang, Andreas, Denger, Caroline, Diener, Frederic, Küppers, Leticia, Soriano-Baguet, Gertrud, Schäfer, Archana K, Yanamandra, Renping, Zhao, Arne, Knörck, Eva C, Schwarz, Martin, Hart, Frank, Lammert, Leticia Prates, Roma, Dirk, Brenner, Grigorios, Christidis, Volkhard, Helms, Eckart, Meese, Markus, Hoth, and Bin, Qu

Subjects
TNF-Related Apoptosis-Inducing Ligand, Phosphatidylinositol 3-Kinases, Receptors, TNF-Related Apoptosis-Inducing Ligand, Glucose, T-Lymphocytes, Cytotoxic
Abstract

TNF-related apoptosis inducing ligand (TRAIL) is expressed on cytotoxic T lymphocytes (CTLs) and TRAIL is linked to progression of diabetes. However, the impact of high glucose on TRAIL expression and its related killing function in CTLs still remains largely elusive. Here, we report that TRAIL is substantially up-regulated in CTLs in environments with high glucose (HG) both

Published
2021

126. ACOX2 deficiency-induced liver fragility (ADILF), a not-so-rare inborn error in bile acid metabolism that responds to ursodeoxycholic acid treatment

Author

Marta Alonso-Peña, Ricardo A. Espinosa-Escudero, Elisa Herraez, Oscar Briz, María Luisa Cagigal, Jesús González Santiago, Aida Ortega-Alonso, Conrado Manuel Fernandez Rodriguez, Luis Bujanda, Marta Calvo, Delia D’Avola, Maria Carlota Londoño, Moises Diago, José Fernandez-Checa, M.Carme Garcia-Ruiz, Raul J. Andrade, Frank Lammert, Jesus Prieto, Javier Crespo, Javier Juampérez Goñi, Álvaro Díaz-González, Maria Monte, and Jose Marin

Subjects
Hepatology
Published
2022

128. S3-Leitlinie: Diagnostik und Therapie des hepatozellulären Karzinoms

Author

Sabrina, Voesch, additional, Michael, Bitzer, additional, Jörg, Albert, additional, Peter, Bartenstein, additional, Wolf, Bechstein, additional, Susanne, Blödt, additional, Thomas, Brunner, additional, Frank, Dombrowski, additional, Matthias, Evert, additional, Markus, Follmann, additional, Christian, La Fougère, additional, Paul, Freudenberger, additional, Andreas, Geier, additional, Eleni, Gkika, additional, Martin, Götz, additional, Elke, Hammes, additional, Thomas, Helmberger, additional, Ralf-Thorsten, Hoffmann, additional, Wolf-Peter, Hofmann, additional, Peter, Huppert, additional, Achim, Kautz, additional, Gabi, Knötgen, additional, Jürgen, Körber, additional, David, Krug, additional, Frank, Lammert, additional, Hauke, Lang, additional, Thomas, Langer, additional, Philipp, Lenz, additional, Andreas, Mahnken, additional, Alexander, Meining, additional, Oliver, Micke, additional, Silvio, Nadalin, additional, Huu Phuc, Nguyen, additional, Johann, Ockenga, additional, Karl-Jürgen, Oldhafer, additional, Philipp, Paprottka, additional, Kerstin, Paradies, additional, Philippe, Pereira, additional, Thorsten, Persigehl, additional, Mathias, Plauth, additional, Ruben, Plentz, additional, Jürgen, Pohl, additional, Jutta, Riemer, additional, Peter, Reimer, additional, Johanna, Ringwald, additional, Ulrike, Ritterbusch, additional, Elke, Roeb, additional, Barbara, Schellhaas, additional, Peter, Schirmacher, additional, Irene, Schmid, additional, Andreas, Schuler, additional, Dietrich, von Schweinitz, additional, Daniel, Seehofer, additional, Marianne, Sinn, additional, Alexander, Stein, additional, Andreas, Stengel, additional, Nadine, Steubesand, additional, Christian, Stoll, additional, Andrea, Tannapfel, additional, Anne, Taubert, additional, Jörg, Trojan, additional, Ingo, van Thiel, additional, Reina, Tholen, additional, Arndt, Vogel, additional, Thomas, Vogl, additional, Hilke, Vorwerk, additional, Frank, Wacker, additional, Oliver, Waidmann, additional, Heiner, Wedemeyer, additional, Henning, Wege, additional, Dane, Wildner, additional, Christian, Wittekind, additional, Marcus-Alexander, Wörns, additional, Peter, Galle, additional, and Nisar, Malek, additional

Published
2022
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129. Liver stiffness as surrogate parameter in emergency assessment for inpatient health care utilization

Author

Dominic, Kaddu-Mulindwa, Marius, von Martial, Angela, Thiel-Bodenstaff, Vadim, Lesan, Sebastian, Ewen, Felix, Mahfoud, Frank, Lammert, and Marcin, Krawczyk

Subjects
Adult, Aged, 80 and over, Liver Cirrhosis, Male, Inpatients, Young Adult, Adolescent, Liver, Elasticity Imaging Techniques, Humans, Middle Aged, Patient Acceptance of Health Care, Aged
Abstract

Transient elastography (TE) allows non-invasive quantification of liver stiffness (LSM) and steatosis (controlled attenuation parameter, CAP). Here we test the feasibility and utility of TE in the emergency department (ED) and investigate whether LSM predicts longer hospitalization and reimbursement for non-elective patients.LSM and CAP were determined in prospectively recruited consecutive adult patients admitted to the ED of a tertiary referral center. Patients were stratified according to the 9.1 kPa and 13.0 kPa LSM cut-offs. Elastography measurements were correlated with clinical and outcome parameters, including duration of hospital stay and hospitalization costs.In 200 ED patients (133 men, age 18 - 97 years), median LSM was 5.5 kPa (2.4 - 69.1 kPa), and median CAP was 252 dB/m (100 - 400 dB/m). In total, 39 patients (19.5%) presented with LSM ≥ 9.1 kPa, and 24 patients (12.0%) presented with LSM ≥ 13.0 kPa. Heart failure (n = 19) was associated with higher LSM (p = 0.045). Patients with LSM ≥ 9.1 kPa were significantly (p0.01) more likely to require longer hospitalization than those with lower LSM. Patients with LSM ≥ 13.0 kPa generated significantly (p = 0.001) higher costs as compared to patients with low LSM.Transient elastography represents an easily accessible screening tool in ED that might help identify patients in need of increased health care resources.

Published
2021

130. [Impact of Covid 19 on endoscopy in Germany]

Author

Maria, Kahn, Stephan, Zellmer, Alanna, Ebigbo, Anna, Muzalyova, Johanna, Classen, Vivien, Grünherz, Janis, Böser, Lutz P, Breitling, Albert, Beyer, Jonas, Rosendahl, Frank, Lammert, Claudia, Traidl-Hoffmann, Helmut, Messmann, and Christoph, Römmele

Subjects
COVID-19 Testing, SARS-CoV-2, Germany, COVID-19, Humans, Endoscopy, Gastrointestinal
Abstract

Practices and hospitals are facing great challenges in coping with the COVID-19-pandemic. So far, data on the impact of the pandemic on gastroenterological facilities are lacking, especially on a temporal course. A database is lacking, especially for the outpatient care sector. University Hospital of Augsburg was commissioned to generate data on this as a part of the collaborative project B-FAST of the Network of University Medicine (NUM).Gastroenterological institutions nationwide were surveyed by an online questionnaire. Recruitment was carried out via the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the Professional Association of Gastroenterologists in Private Practice (bng). This manuscript provides an overview of data on the use of protective equipment, pre-interventional testing of patients, staff screening and economic impact over the course of the pandemic.429 facilities answered the questionnaire. Practices tested their patients pre-interventionally significantly less often than clinics (7.8% vs. 82.6%). In clinics, inpatients (93.1%) were tested significantly more often than outpatients (72.2%). The use of personal protective equipment (PPE) increased significantly during the pandemic. It was shown that over 70% of facilities screened their staff for SARS-CoV-2 without cause. Clinics cancelled elective procedures significantly more often than practices in quarter 4/2020. Procedures and turnover decreased in 2020 compared to the previous year. However, fewer facilities were affected by a loss of revenue than expected in previous studies.Our data demonstrate the variable implementation of pre-interventional SARS-CoV-2 testing in outpatient and inpatient care. The use of adequate PPE and staff screening increased during the pandemic.In der Bewältigung der COVID-19-Pandemie stehen Praxen und Kliniken vor großen Herausforderungen. Zu den Auswirkungen der Pandemie auf gastroenterologische Einrichtungen, insbesondere über einen zeitlichen Verlauf, gibt es bislang kaum Daten. Besonders für den ambulanten Versorgungssektor fehlt eine Datenbasis. Das Universitätsklinikum Augsburg wurde im Rahmen des Verbundprojektes B-FAST des Nationalen Forschungsnetzwerks der Universitätsmedizin beauftragt hierzu Daten zu generieren.Es wurden bundesweit mittels Onlinefragebogen gastroenterologische Einrichtungen befragt. Die Rekrutierung erfolgte über die Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und den Berufsverband niedergelassener Gastroenterologen (bng). Das vorliegende Manuskript gibt einen Überblick über Daten zur Verwendung von Schutzausrüstung, präinterventioneller Testung von Patienten, Mitarbeiterscreenings sowie wirtschaftlichen Auswirkungen über den Pandemieverlauf.429 Einrichtungen beantworteten den Fragebogen. Praxen testeten ihre Patienten präinterventionell signifikant seltener als Kliniken (7,8 % vs. 82,6 %). In Kliniken wurden stationäre Patienten (93,1 %) signifikant häufiger getestet als ambulante Patienten (72,2 %). Die Verwendung von persönlicher Schutzausrüstung (PSA) nahm im Verlauf der Pandemie signifikant zu. Es konnte gezeigt werden, dass über 70 % der Einrichtungen ihre Mitarbeiter nicht-anlassbezogen auf SARS-CoV-2 screenten. Kliniken sagten im Quartal 4/2020 signifikant häufiger elektive Prozeduren ab als Praxen. Die durchgeführten Prozeduren und die Umsatzentwicklung nahmen 2020 im Vergleich zum Vorjahr ab. Jedoch waren weniger Einrichtungen von einem Umsatzverlust betroffen als in vorangegangenen Studien erwartet wurde.Unserer Daten veranschaulichen die unterschiedliche Umsetzung präinterventioneller SARS-CoV-2 Testung in der ambulanten und stationären Patientenversorgung. Die Verwendung adäquater PSA und Mitarbeiterscreeningmaßnahmen konnten im Verlauf der Pandemie gesteigert werden.

Published
2021

131. Gemeinsames Positionspapier der DGVS, der DEGEA, der DGE-BV, des BVGD, der ALGK und des bng zum aktuellen Stand und den prinzipiellen Möglichkeiten der Delegation ärztlicher Tätigkeiten im Bereich Gastroenterologie (für Klinik und Praxis)

Author

Joachim Labenz, Ute Pfeifer, Siegbert Faiss, Alexander Meining, Thomas Frieling, Frank Lammert, Albert Beyer, Dieter Schilling, Ulrich Rosien, Gero Moog, Helmut Messmann, Peter Hüttl, Till Wehrmann, Ulrike Beilenhoff, Hans-Dieter Allescher, Horst Neuhaus, and Jutta Keller

Subjects
business.industry, Medicine, business
Published
2021

132. Health-care workers in gastrointestinal endoscopy are at higher risk for SARS-CoV-2 infection compared to other aerosol-generating disciplines

Author

Helmut Messmann, Albert Beyer, Claudia Traidl-Hoffmann, Christoph Arens, Jonas Rosendahl, Frank Lammert, Tilo Schlittenbauer, Johannes Zenk, Christina C. Bartenschlager, Roland Frankenberger, Maria Kahn, Stephan Zellmer, Alanna Ebigbo, Juergen Hoffmann, Gertrud Hammel, Bilal Al-Nawas, Christoph Roemmele, and Anna Muzalyova

Subjects
medicine.medical_specialty, Multivariate analysis, Ambulatory care, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Internal medicine, Risk of infection, Health care, Specialty, Medicine, It impact, business, Gastrointestinal endoscopy
Abstract

ObjectiveHealthcare workers (HCW) are at high risk of SARS-CoV-2 infection due to exposure to potentially infectious material, especially during aerosol-generating procedures (AGP). We aimed to investigate the prevalence of infection among HCW in medical disciplines with AGP.DesignA nationwide questionnaire-based study in in- and outpatient settings was conducted between 12/16/2020 and 01/24/2021. Data on SARS-CoV-2 infections among HCW and potential risk factors were investigated.Results2,070 healthcare facilities with 25,113 employees were included in the study. Despite a higher rate of pre-interventional testing, clinics treated three times more confirmed SARS-CoV-2 cases than private practices (28.8% vs. 88.4%, pConclusionHCW in GIE seem to be at higher risk of infection than those in other AGP, especially in the clinical setting. Regions having comparably higher incidences as well as the number of procedures performed per day were also significantly associated with increased risk of infection.Significance of this studyWhat is already known on this subject?Health care workers, especially those exposed to aerosol generating procedures, are assumed to have an increased risk of SARS-CoV-2 infection. However, data confirming this are lacking, especially for the outpatient care setting.What are the new findings?Health care workers in gastrointestinal endoscopy have a higher risk of SARS-CoV-2-infection than in other AGPs. This risk is particularly higher-in clinical settings compared to private practices-in regions having comparably higher incidences-the more procedures are performed per dayHow might it impact on clinical practice in the foreseeable future?Our study suggests making additional efforts to protect HCW in the gastrointestinal work field.

Published
2021

133. Autoantibodies against Progranulin and IL-1 receptor antagonist due to immunogenic posttranslational isoforms contribute to hyperinflammation in critically ill COVID-19

Author

Frederik Seiler, Frank Lammert, Sebastian Mang, Onur Cetin, Matthias C. Reichert, Klaus Roemer, Andreas Link, Phiilpp Agne, Zanir Abdi, Sylvia Hartmann, Thorsten Pfuhl, Soeren L Becker, Angela Thiel-Bodenstaff, Christian Lensch, Frank Langer, Frank Neumann, Sixten Körper, Dominic Kaddu-Mulindwa, Christian Herr, Thomas Adams, Christoph Kessel, Lorenz Thurner, Bernhard Thurner, Klaus-Dieter Preuss, Konstantinos Christofyllakis, Sophie Roth, Marie-Christin Hoffmann, Theresa Bock, Bettina Friesenhahn-Ochs, Stephan Stilgenbauer, Dirk Foell, Evi Regitz, Vadim Lesan, Patrick Wächter, Yvan Fischer, Joerg Thomas Bittenbring, Jürgen Rissland, Carlos Metz, Philipp M. Lepper, Guy Danziger, Birgit Bette, Jan Pilch, Cihan Papan, Torben Rixecker, Claudia Schormann, Marcin Krawczyk, Stefan Lohse, Gereon Gaebelein, Johannes Lehmann, Angelika Bick, André Becker, Igor Kos, Hubert Schrezenmeier, Michael Boehm, Christian Werner, Moritz Bewarder, Robert Bals, Natalie Fadle, and Sigrun Smola

Subjects
CD40, biology, business.industry, medicine.drug_class, Autoantibody, SERPINB1, Disease, Receptor antagonist, Immune system, Antigen, Immunology, biology.protein, Medicine, Antibody, business
Abstract

Hyperinflammation is frequently observed in patients with severe COVID-19. Inadequate and defective IFN type I responses against SARS-CoV-2, associated with autoantibodies in a proportion of patients, lead to severe courses of disease. In addition, hyperactive responses of the humoral immune system have been described. In the current study we investigated a possible role of neutralizing autoantibodies against anti-inflammatory mediators. Plasma from adult patients with severe and critical COVID-19 was screened by ELISA for antibodies against PGRN, IL-1-Ra, IL-10, IL-18BP, IL-22BP, IL-36-Ra, CD40, IFN-α2, IFN-γ, IFN-ω and serpinB1. Autoantibodies were characterized and the antigens were analyzed for immunogenic alterations. In a discovery cohort with severe to critical COVID-19 high titers of PGRN-autoantibodies were detected in 11 of 30 (36.7%), and of IL-1-Ra-autoantibodies in 14 of 30 (46.7%) patients. In a validation cohort of 64 patients with critical COVID-19 high-titer PGRN-Abs were detected in 25 (39%) and IL-1-Ra-Abs in 32 of 64 patients (50%). PGRN-Abs and IL-1-Ra-Abs belonged to IgM and several IgG subclasses. In separate cohorts with non-critical COVID-19, PGRN-Abs and IL-1-Ra-Abs were detected in low frequency (i.e. in < 5% of patients) and at low titers. Neither PGRN- nor IL-1-Ra-Abs were found in 40 healthy controls vaccinated against SARS-CoV-2 or 188 unvaccinated healthy controls. PGRN-Abs were not cross-reactive against SARS-CoV-2 structural proteins nor against IL-1-Ra. Plasma levels of both free PGRN and free IL-1-Ra were significantly decreased in autoantibody-positive patients compared to Ab-negative and non-COVID-19 controls. In vitro PGRN-Abs from patients functionally reduced PGRN-dependent inhibition of TNF-α signaling, and IL-1-Ra-Abs from patients reduced IL-1-Ra- or anakinra-dependent inhibition of IL-1ß signaling. The pSer81 hyperphosphorylated PGRN isoform was exclusively detected in patients with high-titer PGRN-Abs; likewise, a hyperphosphorylated IL-1-Ra isoform was only found in patients with high-titer IL-1-Ra-Abs. Thr111 was identified as the hyperphophorylated amino acid of IL-1-Ra. In longitudinally collected samples hyperphosphorylated isoforms of both PGRN and IL-1-Ra emerged transiently, and preceded the appearance of autoantibodies. In hospitalized patients, the presence of IL-1-Ra-Abs or IL-1-Ra-Abs in combination with PGRN-Abs was associated with a higher morbidity and mortality.To conclude, neutralizing autoantibodies to IL-1-Ra and PGRN occur in a significant portion of patients with critical COVID-19, with a concomitant decrease in circulating free PGRN and IL-1-Ra, indicative of a misdirected, proinflammatory autoimmune response. The break of self-tolerance is likely caused by atypical hyperphosphorylated isoforms of both antigens, whose appearances precede autoantibody induction. Our data suggest that these immunogenic secondary modifications are induced by the SARS-CoV-2-infection itself or the inflammatory environment evoked by the infection and predispose for a critical course of COVID-19.

Published
2021

134. Einfluss der Augmentationstherapie mit Alpha1-Antitrypsin auf den Leberphänotyp von Individuen mit klassischem Alpha1-Antitrypsin-Mangel (Genotyp Pi*ZZ)

Author

Matthias C. Reichert, C Lindhauer, M Mandorfer, Robert Bals, Elmar Aigner, Thorhauge K Holtz, Joan Genescà, Rembert Koczulla, Carolin V. Schneider, Aleksander Krag, V Woditsch, A Teumer, Joanna Chorostowska-Wynimko, Pavel Strnad, Christian Trautwein, Karim Hamesch, William J.H. Griffiths, Marc Miravitlles, Malin Fromme, Federica Benini, Sabina Janciauskiene, M Trauner, Frank Lammert, V Pereira, Mònica Pons, and J Voß

Published
2021

135. Neglected geriatric assessment and overtreatment of older patients with pancreatic cancer - Results from a prospective phase IV clinical trial

Author

Johannes Betge, Nadine Schulte, Sebastian Belle, Tianzuo Zhan, Beate Krammer-Steiner, Jean-Charles Moulin, Matthias Kleiß, Frank Lammert, Ulrich Wedding, Sebastian Räth, Martin Maenz, Lisa Hegele, Julian Larcher-Senn, Ralf Jesenofsky, Matthias P. Ebert, and Nicolai Härtel

Subjects
Overtreatment, Paclitaxel, Adenocarcinoma, Pancreatic Neoplasms, Oncology, Albumins, Activities of Daily Living, Antineoplastic Combined Chemotherapy Protocols, Quality of Life, Humans, Prospective Studies, Geriatrics and Gerontology, Geriatric Assessment, Aged
Abstract

Older patients with metastatic pancreatic cancer may suffer increased toxicity from intensive chemotherapy. Treatment individualization by geriatric assessment (GA) might improve functional outcome.We performed a multicenter, phase IV, open label trial in patients ≥70 years with metastatic pancreatic adenocarcinoma. Patients underwent GA and were assigned to one of three categories based on their scores: Go-Go, Slow-Go, or Frail. These categories were intended to guide physician's treatment decisions when choosing to treat patients with nab-paclitaxel/gemcitabine (arm A), gemcitabine (arm B), or best supportive care (arm C). Primary objective was a stable (loss of five points or less) Barthel's Activities of Daily Living (ADL) score during chemotherapy; secondary endpoints included GA scores during therapy, safety, quality of life, response and survival rates.Thirty-two patients were enrolled in the trial in six centers in Germany (out of 135 planned), resulting in termination due to low recruitment. Fifteen patients were allocated to nab-paclitaxel/gemcitabine, fifteen to gemcitabine, and two to best supportive care by their physicians, although according to their GA scores 29 patients (91%) were categorized as Slow-Go and three (9%) as Go-Go. Thus, fifteen of 32 (47%) patients were misclassified and given a course of treatment inconsistent with their GA scores. Median progression-free survival (PFS) were 3.3 months and 9.1 months and median time to quality-of-life deterioration 13 days and 29 days in the nab-paclitaxel/gemcitabine and gemcitabine monotherapy arms, respectively. Serious adverse events were reported in 11 (78.6%) patients in the nab-paclitaxel/gemcitabine and 8 (53.3%) patients in the gemcitabine arm.Clinical evaluations by investigators differed markedly from geriatric assessments, leading to potential overtreatment. In our modest sample size study, those patients undergoing more intensive therapy had a less favorable course.

Published
2021

136. Variants APOE (rs429358) and TM6SF2 (rs187429064) confer risk to hepatocellular carcinoma

Author

E Barnes, Thomas Reiberger, Markus Casper, Jens U. Marquardt, Philipp Lutz, S Sulk, Hans Dieter Nischalke, Thomas Berg, Pierre Deltenre, John McLauchlan, Jonel Trebicka, Clemens Schafmayer, William L. Irving, Morling, Felix Stickel, V Hamill, Jochen Hampe, Daniel Gotthardt, Jonas Rosendahl, Stephan Buch, Janett Fischer, Jennifer Benselin, Karl-Heinz Weiss, J von Felden, Georg Semmler, Frank Lammert, Hamish Innes, Luca Valenti, Arndt Vogel, Christian Datz, Astrid Marot, Indra Neil Guha, V Pedergnana, Alexander Link, A. Ansari, Florian Eyer, and S Müller

Subjects
Apolipoprotein E, business.industry, Hepatocellular carcinoma, Cancer research, Medicine, business, medicine.disease, TM6SF2
Published
2021

137. O10 Granulocyte-Colony Stimulating Factor (G-CSF) to treat acute-on-chronic liver failure; results of the first multicenter randomized trial (GRAFT study)

Author

Katrin Splith, Jonel Trebicka, Christoph P. Berg, Dieter Häussinger, Thomas Berg, Frank Erhard Uschner, Jan Pfeiffenberger, Alexander Zipprich, Ingolf Schiefke, Annegret Franke, Moritz Schmelzle, Christoph Sarrazin, Christian M. Lange, Tobias Goeser, Ali Canbay, Tony Ildh, Frank Lammert, Michael Manns, Tobias Mueller, Peter R. Galle, Christian Trautwein, Niklas Aehling, Stefan Zeuzem, Adam Herber, Cornelius Engelmann, and Anett Schmiedeknecht

Subjects
medicine.medical_specialty, Randomized controlled trial, law, business.industry, Internal medicine, medicine, Acute on chronic liver failure, business, Gastroenterology, law.invention, Granulocyte colony-stimulating factor
Published
2021

138. Ein Jahr Covid-19: Testung, Verwendung von Schutzausrüstung und Auswirkungen auf die Gastrointestinale Endoskopie in Deutschland

Author

Alanna Ebigbo, Helmut Messmann, Johanna Classen, Jonas Rosendahl, Claudia Traidl-Hoffmann, Vivien Grünherz, Maria Kahn, Anna Muzalyova, Frank Lammert, Albert Beyer, Lutz P Breitling, Stephan Zellmer, Janis Böser, and Christoph Römmele

Subjects
medicine.medical_specialty, Inpatient care, business.industry, Gastroenterology, MEDLINE, Computer-assisted web interviewing, Ambulatory care, Private practice, Family medicine, Pandemic, Medicine, Professional association, ddc:610, business, Personal protective equipment
Abstract

Zusammenfassung Hintergrund In der Bewältigung der COVID-19-Pandemie stehen Praxen und Kliniken vor großen Herausforderungen. Zu den Auswirkungen der Pandemie auf gastroenterologische Einrichtungen, insbesondere über einen zeitlichen Verlauf, gibt es bislang kaum Daten. Besonders für den ambulanten Versorgungssektor fehlt eine Datenbasis. Das Universitätsklinikum Augsburg wurde im Rahmen des Verbundprojektes B-FAST des Nationalen Forschungsnetzwerks der Universitätsmedizin beauftragt hierzu Daten zu generieren. Methode Es wurden bundesweit mittels Onlinefragebogen gastroenterologische Einrichtungen befragt. Die Rekrutierung erfolgte über die Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und den Berufsverband niedergelassener Gastroenterologen (bng). Das vorliegende Manuskript gibt einen Überblick über Daten zur Verwendung von Schutzausrüstung, präinterventioneller Testung von Patienten, Mitarbeiterscreenings sowie wirtschaftlichen Auswirkungen über den Pandemieverlauf. Ergebnisse 429 Einrichtungen beantworteten den Fragebogen. Praxen testeten ihre Patienten präinterventionell signifikant seltener als Kliniken (7,8 % vs. 82,6 %). In Kliniken wurden stationäre Patienten (93,1 %) signifikant häufiger getestet als ambulante Patienten (72,2 %). Die Verwendung von persönlicher Schutzausrüstung (PSA) nahm im Verlauf der Pandemie signifikant zu. Es konnte gezeigt werden, dass über 70 % der Einrichtungen ihre Mitarbeiter nicht-anlassbezogen auf SARS-CoV-2 screenten. Kliniken sagten im Quartal 4/2020 signifikant häufiger elektive Prozeduren ab als Praxen. Die durchgeführten Prozeduren und die Umsatzentwicklung nahmen 2020 im Vergleich zum Vorjahr ab. Jedoch waren weniger Einrichtungen von einem Umsatzverlust betroffen als in vorangegangenen Studien erwartet wurde. Schlussfolgerung Unserer Daten veranschaulichen die unterschiedliche Umsetzung präinterventioneller SARS-CoV-2 Testung in der ambulanten und stationären Patientenversorgung. Die Verwendung adäquater PSA und Mitarbeiterscreeningmaßnahmen konnten im Verlauf der Pandemie gesteigert werden.

Published
2021

140. High glucose enhances antigen-independent CTL killing via TRAIL

Author

Gertrud Schäfer, Volkhard Helms, Markus Hoth, Grigorios Christidis, Arne Knörck, Archana K. Yanamandra, Eva C. Schwarz, Caroline Diener, Leticia Soriano-Baguet, Eckart Meese, Leticia Prates Roma, Frank Lammert, Martin Hart, Bin Qu, Wenjuan Yang, Frederic Küppers, Dirk Brenner, Renping Zhao, and Andreas Denger

Subjects
chemistry.chemical_classification, CTL, Reactive oxygen species, Antigen, Downregulation and upregulation, Chemistry, Apoptosis, medicine, Cancer research, Cytotoxic T cell, In vitro, Metformin, medicine.drug
Abstract

Cytotoxic T lymphocytes (CTLs) are involved in development of diabetes. However, the impact of excessive glucose on CTL-mediated antigen-independent killing remains elusive. Here, we report that TNF-related apoptosis inducing ligand (TRAIL) is substantially up- regulated in CTLs in environments with high glucose (HG) both in vitro and in vivo. The PI3K- Akt-NFκB axis and non-mitochondrial reactive oxygen species are essential in HG-induced TRAIL upregulation in CTLs. TRAILhigh CTLs induce apoptosis of pancreatic beta cell line 1.4E7. Metformin and Vitamin D synergistically reduce HG-enhanced expression of TRAIL in CTLs and coherently protect 1.4E7 cells from TRAIL-mediated apoptosis. Notably, in patients with diabetes, correlation between Vitamin D concentrations in plasma and glucose levels is linked to HG-enhanced TRAIL expression on CTLs. Microarray data reveal that OXCT2, an important enzyme in ketone body catabolism, is a promising target in response to vitamin D. Our work not only reveals a novel mechanism of CTL involvement in progression of diabetes, but also establishes CTLs as a target for combined metformin and vitamin D therapy to protect pancreatic beta cells of diabetic patients.

Published
2021

141. [Quality management in the field of gastroenterology - Proposals of the Quality Commission of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) for Outpatient and Inpatient Quality Assurance]

Author

Ludger, Leifeld, Ulrike, Denzer, Thomas, Frieling, Ralf, Jakobs, Herbert, Koop, Pia, van Leeuwen, Ahmed, Madisch, Ulrich, Rosien, Albrecht, Stier, Britta, Siegmund, Ulrich, Tappe, Frank, Lammert, and Petra, Lynen Jansen

Subjects
Inpatients, Metabolic Diseases, Germany, Outpatients, Gastroenterology, Humans
Abstract

The quality of the medical care depends on numerous factors that can often be influenced by the doctor itself. It is a great challenge to follow the constant scientific progress in practice. Scientific standards in gastroenterology are defined in DGVS guidelines and regularly revised. The implementation of evidence-based recommendations in practice remains challenging. On the basis of the DGVS guidelines, the Quality Commission has therefore developed a selection of quality indicators with particular relevance using standardized criteria, the broad implementation of which could contribute to improved patient care in gastroenterology.Die Qualität der ärztlichen Tätigkeit ist von zahlreichen Faktoren abhängig. Insbesondere die Prozessqualität ist durch ärztliches Handeln direkt beeinflussbar. Eine große Herausforderung ist es dabei den steten wissenschaftlichen Fortschritt in der Praxis zu folgen. Die wissenschaftlichen Standards in der Gastroenterologie werden in DGVS Leitlinien definiert und regelmäßig überarbeitet. Die Umsetzung der vielfältigen evidenzbasierten Empfehlungen in die Praxis bleibt aber anspruchsvoll. Auf Basis der DGVS Leitlinien hat die Kommission Qualität daher eine Auswahl von Qualitätsindikatoren mit besonderer Relevanz anhand standardisierter Kriterien erarbeitet, deren breite Umsetzung zu einer verbesserten Patientenversorgung in der Gastroenterologie beitragen würde.

Published
2021

142. Visualising and quantifying intestinal permeability -where do we stand

Author

M Rusticeanu, Frank Lammert, and Vincent Zimmer

Subjects
liver cirrhosis, Specialties of internal medicine, Permeability, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Barrier integrity, Intestinal Mucosa, functional imaging, Confocal laser endomicroscopy, Microscopy, Confocal, Intestinal permeability, Hepatology, Gut barrier, business.industry, intestinal permeability, General Medicine, medicine.disease, Magnetic Resonance Imaging, intestinal imaging, Clinical Practice, Intestinal Absorption, RC581-951, Positron-Emission Tomography, 030220 oncology & carcinogenesis, CLE, 030211 gastroenterology & hepatology, business, Neuroscience
Abstract

Intestinal permeability is getting more and more attention in gastrointestinal research. Although well recognized, its exact role in health and disease is yet to be defined. There are many methods of quantifying intestinal permeability, but most of them fail to deliver tangible information about the morphological integrity of the intestinal barrier. In this review we aim to describe imaging options for the assessment of intestinal barrier integrity and their potential relevance for clinical practice. Our focus is on confocal laser endomicroscopy, which is at this time the only method for visualizing not only functional but also morphological aspects of the gut barrier in vivo.

Published
2021

143. Low Accuracy of FIB-4 and NAFLD Fibrosis Scores for Screening for Liver Fibrosis in the Population

Author

Isabel Graupera, Maja Thiele, Miquel Serra-Burriel, Llorenç Caballeria, Dominique Roulot, Grace Lai-Hung Wong, Núria Fabrellas, Indra Neil Guha, Anita Arslanow, Carmen Expósito, Rosario Hernández, Guruprasad Padur Aithal, Peter R. Galle, Guillem Pera, Vincent Wai-Sun Wong, Frank Lammert, Pere Ginès, Laurent Castera, and Aleksander Krag

Subjects
Adult, Male, Liver Cirrhosis, Hepatology, Biopsy, Gastroenterology, Middle Aged, Fibrosis, Severity of Illness Index, Liver, Non-alcoholic Fatty Liver Disease, Prevalence, Humans, Female, Aged
Abstract

Fibrosis-4 (FIB-4) and the nonalcoholic fatty liver disease fibrosis score (NFS) are the 2 most popular noninvasive blood-based serum tests proposed for widespread fibrosis screening. We therefore aimed to describe the accuracy of FIB-4 and NFS to detect elevated liver stiffness as an indicator of hepatic fibrosis in low-prevalence populations.This study included a total of 5129 patients with concomitant measurement of FIB-4, NFS, and liver stiffness measurement (LSM) by Fibroscan (Echosens, France) from 5 independent population-based cohorts from Spain, Hong Kong, Denmark, England, and France; 3979 participants from the general population and 1150 from at-risk cohorts due to alcohol, diabetes, or obesity. We correlated LSM with FIB-4 and NFS, and calculated pre- and post-test predictive values of FIB-4 and NFS to detect elevated LSM at 8 kPa and 12 kPa cutoffs. The mean age was 53 ± 12 years, the mean body mass index was 27 ± 5 kg/mFIB-4 and NFS are suboptimal for screening purposes due to a high risk of overdiagnosis and a non-negligible percentage of false-negatives, especially in patients with risk factors for chronic liver disease. Waist circumference emerged as a potential first step to identify patients at risk for liver fibrosis in the general population.

Published
2021

144. Acute Pancreatitis in the Setting of Hepatitis E Virus (Genotype 3) Infection and Compound CLDN2-PRSS1 Risk Variants

Author

Frank Lammert, Marcin Krawczyk, Johannes Lehmann, Simina Muresan, and Susanne N Weber

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Hepatitis E virus genotype, MEDLINE, medicine.disease, Gastroenterology, Endocrinology, Internal medicine, Internal Medicine, Medicine, Acute pancreatitis, business
Published
2020

145. Gastrointestinal endoscopy during extracorporeal membrane oxygenation (ECMO) for COVID-19

Author

Philipp M. Lepper, Matthias C. Reichert, Markus Casper, Guy Danziger, Robert Bals, Marcin Krawczyk, Frank Lammert, and Frederik Seiler

Subjects
2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), medicine.diagnostic_test, business.industry, medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Gastroenterology, Endoscopy, Anesthesia, Extracorporeal membrane oxygenation, medicine, Interdisciplinary communication, business, Coronavirus Infections, Gastrointestinal endoscopy
Published
2020

146. Serum and urine extracellular vesicles contain specific RNAs with diagnostic capacity for cholangiocarcinoma, being possibly involved in disease pathogenesis

Author

Ainhoa Lapitz, Pedro Miguel Rodrigues, Ander Arbelaiz, José Luis Lavin, Colm O Rourke, Marcin Krawczyk, Alvaro Santos-Laso, María Jesús Perugorria, Adelaida La Casta, Raul Jimenez-Aguero, Cesar Ibarra, Alberto Sanchez-Campos, Juan Pablo Jimeno, Ioana Riaño, Esperanza Gonzalez, Frank Lammert, Marco Marzioni, Rocio IR Macias, Jose Marin, Tom Hemming Karlsen, Luis Bujanda, Juan Falcon-Perez, Jesper Andersen, Ana María Aransay, and Jesus M. Banales

Subjects
Hepatology
Published
2020

149. Efficacy of rituximab in difficult-to-manage autoimmune hepatitis: Results from the International Autoimmune Hepatitis Group

Author

Andrew James Godkin, Michael P. Manns, Ye Htun Oo, Nwe Ni Than, Meemee Botter, James Hodson, David H. Adams, Mark G. Swain, Rebecca E. Wawman, Daniel Schmidt-Martin, Kelly W. Burak, Aldo J. Montano-Loza, Richard Taubert, Rebecca L Jones, Gautham D Appanna, Frank Lammert, Nishant Gautam, Christoph Schramm, Gideon M. Hirschfield, Kilian Bock, and HZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.

Subjects
medicine.medical_specialty, Prednisolone, Autoimmune hepatitis, Gastroenterology, Immune system, Difficult-to-manage, immune system diseases, Internal medicine, Internal Medicine, medicine, Immunology and Allergy, lcsh:RC799-869, Adverse effect, Liver injury, Hepatology, business.industry, Retrospective cohort study, medicine.disease, B cell depletion therapy, Dose reduction, Rituximab, lcsh:Diseases of the digestive system. Gastroenterology, business, medicine.drug, Research Article
Abstract

Background & Aims Treatment options remain limited for patients with autoimmune hepatitis (AIH), while there are still concerns over the consequences of long-term corticosteroid use. A few studies have suggested a role for B cell-driven autoimmune liver injury in AIH. This multicentre, international retrospective cohort study from the International Autoimmune Hepatitis Group aims to evaluate the clinical efficacy and safety of rituximab in difficult-to-manage AIH. Methods Clinical data from 22 patients who received rituximab between 2007 and 2017 were collected from centres in the United Kingdom, Germany and Canada. Clinical response was assessed using changes in biochemical and immunological parameters up to 24 months post-rituximab infusion. In addition, we compared the doses of prednisolone used 3 months before and 12 months after treatment, and assessed freedom from AIH flares over the post-treatment period. Results Twenty-two patients with type-1 AIH were included, with a median age of 40 years at diagnosis (range 19–79); 15/22 (68%) were female and 18/22 (82%) were Caucasian. The median period from diagnosis to the end of follow-up in these patients was 11 years (range 3–28). Values of alanine aminotransferase, aspartate aminotransferase and albumin improved significantly following rituximab therapy, and were sustained for up to 2 years (all p ≪0.001). Prednisolone doses were significantly reduced by 12 months post-treatment (p = 0.003), with 13/21 (62%) patients having a dose reduction. Over a median post-treatment follow-up period of 6 years (range 1–10), 5 patients developed AIH flares at a median of 22 months post-treatment, giving an estimated 71% freedom from AIH flare at 2 years. Four of these patients received a second course of treatment, of whom 2 had subsequent further flares. No serious adverse events attributable to rituximab were recorded. Conclusion In patients with difficult-to-manage AIH, rituximab appears to be clinically effective and well tolerated. Rituximab was associated with sustained improvements in serum liver tests, an absence of clinical disease flares, and a reduction in prednisolone dose. Controlled trials are warranted to further evaluate B cell-targeting therapies in patients with AIH. Lay summary Autoimmune hepatitis is an autoimmune condition of the liver, usually treated with medications that suppress the immune system, such as steroids. However, some patients do not respond to this treatment. We analysed the safety and efficacy of rituximab in patients who were not responding to first- or second-line therapies. Rituximab was safe and improved liver blood tests in 70% of patients over a 2-year follow-up period, while enabling steroid doses to be reduced in two-thirds of patients, which is a very positive clinical outcome., Graphical abstract Unlabelled Image, Highlights • Study of rituximab therapy in 22 patients with autoimmune hepatitis over a follow-up period of 24 months. • No serious adverse events were noted during follow-up in patients treated with rituximab. • Rituximab therapy improved liver enzymes significantly during the 2 years of follow-up. • Prednisolone dose reductions were seen in 62% of patients at 12-month follow-up. • A total of 71% of patients were free of AIH flares during the 24 months of follow-up.

Published
2019

150. Non-Alcoholic Fatty Liver Disease in Non-Obese Individuals: Prevalence, Pathogenesis and Treatment

Author

Piero Portincasa, Marcin Krawczyk, Ewa Stachowska, Frank Lammert, and Emilio Molina-Molina

Subjects
medicine.medical_specialty, Disease, digestive system, Gastroenterology, Pathogenesis, 03 medical and health sciences, 0302 clinical medicine, Non obese, Non-alcoholic Fatty Liver Disease, Internal medicine, Diabetes mellitus, Prevalence, medicine, Humans, 2. Zero hunger, Hepatology, business.industry, Fatty liver, nutritional and metabolic diseases, Non alcoholic, medicine.disease, digestive system diseases, 3. Good health, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Metabolic syndrome, business, Body mass index
Abstract

Non-alcoholic fatty liver disease (NAFLD) parallels comorbidities such as metabolic syndrome, dyslipidaemia or diabetes. Although NAFLD is very prevalent in overweight-obese individuals (i.e. body mass index ≥25 kg/m2), recent studies point to the presence of NAFLD in non-obese individuals, for both the Asian (25 kg/m2) and Caucasian (30 kg/m2) populations. This paper discusses the pathogenic pathways and current treatment options of NAFLD in non-obese populations. In this respect, non-obese subjects also need to undergo the medical screening for NAFLD. Across the scientific community, we aim to promote the advancement of knowledge in this emerging field.

Published
2019

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