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1Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma显示文摘AIM:To investigate the efficacy of transcatheter embolization/chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. METHODS:A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrastenhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2,infused over 30 min using a peristaltic pump,and followed by Lipiodol and Gelfoam embolization. RESULTS:Patients characteristics were:mean age,62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size,3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm,n = 51; 2.1-3.0 cm,n = 35; 3.1-4.0 cm,n = 29; 4.1-5.0 cm,n = 22; 5.1-6.0 cm,n = 11; and > 6.0 cm,n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%),massive (90%-99%) necrosis in 16 patients (10%),partial (50%-89%) necrosis in 18 patients (11%) and poor (< 50%) necrosis in the remaining 34 patients (21%). The rate of complete necrosis according to the HCC size class was:69%,69%,52%,68%,50% and,13% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. Kaplan-Mayer survival at 24-mo was 88%,68%,59%,59%,45%,and 53% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. CONCLUSION:Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm,TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis.Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis Petridis Settimo Caruso Gianluca Marrone Giuseppe Mamone Giovanni Vizzini Angelo Luca Bruno Gridelli 2007World Journal of Gastroenterology2007,13,21:38
2Intestinal permeability in the pathogenesis of liver damage: From non-alcoholic fatty liver disease to liver transplantation显示文摘The intimate connection and the strict mutual cooperation between the gut and the liver realizes a functional entity called gut-liver axis.The integrity of intestinal barrier is crucial for the maintenance of liver homeostasis.In this mutual relationship,the liver acts as a second firewall towards potentially harmful substances translocated from the gut,and is,in turn,is implicated in the regulation of the barrier.Increasing evidence has highlighted the relevance of increased intestinal permeability and consequent bacterial translocation in the development of liver damage.In particular,in patients with non-alcoholic fatty liver disease recent hypotheses are considering intestinal permeability impairment,diet and gut dysbiosis as the primary pathogenic trigger.In advanced liver disease,intestinal permeability is enhanced by portal hypertension.The clinical consequence is an increased bacterial translocation that further worsens liver damage.Furthermore,this pathogenic mechanism is implicated in most of liver cirrhosis complications,such as spontaneous bacterial peritonitis,hepatorenal syndrome,portal vein thrombosis,hepatic encephalopathy,and hepatocellular carcinoma.After liver transplantation,the decrease in portal pressure should determine beneficial effects on the gut-liver axis,although are incompletely understood data on the modifications of the intestinal permeability and gut microbiota composition are still lacking.How the modulation of the intestinal permeability could prevent the initiation and progression of liver disease is still an uncovered area,which deserves further attention.Alberto Nicoletti Francesca Romana Ponziani Marco Biolato Venanzio Valenza Giuseppe Marrone Gabriele Sganga Antonio Gasbarrini Luca Miele Antonio Grieco 2019World Journal of Gastroenterology2019,25,33:19
3Chronic HCV infection and inflammation:Clinical impact on hepatic and extra-hepatic manifestations显示文摘The liver has a central role in regulating inflammation by its capacity to secrete a number of proteins that control both local and systemic inflammatory responses. Chronic inflammation or an exaggerated inflammatory response can produce detrimental effects on target organs. Chronic hepatitis C virus(HCV) infection causes liver inflammation by complex and not yet well-understood molecular pathways, including direct viral effects and indirect mechanisms involving cytokine pathways,oxidative stress and steatosis induction. An increasing body of evidence recognizes the inflammatory response in chronic hepatitis C as pathogenically linked to the development of both liver-limited injury(fibrosis, cirrhosis and hepatocellular carcinoma) and extrahepatic HCV-related diseases(lymphoproliferative disease,atherosclerosis, cardiovascular and brain disease). Defining the complex mechanisms of HCV-induced inflammation could be crucial to determine the global impact of infection, to estimate progression of the disease, and to explore novel therapeutic approaches to avert HCVrelated diseases. This review focuses on HCV-related clinical conditions as a result of chronic liver and systemic inflammatory states.Rosa Zampino Aldo Marrone Luciano Restivo Barbara Guerrera Ausilia Sellitto Luca Rinaldi Ciro Romano Luigi E Adinolfi 2013World Journal of Hepatology2013,5,10:13
4Interventional radiology procedures in adult patients who underwent liver transplantation显示文摘Interventional radiology has acquired a key role in every liver transplantation(LT)program by treating the majority of vascular and non-vascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplantation.The aim of this paper is to review indications,technical consideration,results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.Roberto Miraglia Luigi Maruzzelli Settimo Caruso Mariapina Milazzo Gianluca Marrone Giuseppe Mamone Vincenzo Carollo Salvatore Gruttadauria Angelo Luca Bruno Gridelli 2009World Journal of Gastroenterology2009,15,6:11
5Multidisciplinary imaging of liver hydatidosis显示文摘Liver hydatidosis is a parasitic endemic disease affecting extensive areas in our planet,a significant stigma within medicine to manage because of its incidence,possible complications,and diagnostic involvements.The diagnosis of liver hydatidosis should be as fast as possible because of the relevant complications that may arise with disease progression,involving multiple organs and neighboring structures causing disruption,migration,contamination.The aim of this essay is to illustrate the role of imaging as ultrasonography(US),multi detector row computed tomography,and magnetic resonance imaging(MRI)in the evaluation of liver hydatidosis:the diagnosis,the assessment of extension,the identification of possible complications and the monitoring the response to therapy.US is the screening method of choice.Computed tomography(CT)is indicated in cases in which US is inadequate and has high sensitivity and specificity for calcified hydatid cysts.Magnetic resonance is the best imaging procedure to demonstrate a cystic component and to show a biliary tree involvement.Diagnostic tests such as CT and MRI are mandatory in liver hydatidosis because they allow thorough knowledge regarding lesion size,location,and relations to intrahepatic vascular and biliary structures,providing useful information for effective treatment and decrease in post-operative morbidity.Hydatid disease is classified into four types on the basis of their radiologic appearance.Gianluca Marrone Francesca Crino' Settimo Caruso Giuseppe Mamone Vincenzo Carollo Mariapina Milazzo Salvatore Gruttadauria Angelo Luca Bruno Gridelli 2012World Journal of Gastroenterology2012,18,13:10
6Chronic hepatitis C virus infection and neurological and psychiatric disorders:An overview显示文摘Hepatitis C virus(HCV)infection is considered a systemic disease because of involvement of other organs and tissues concomitantly with liver disease.Among the extrahepatic manifestations,neuropsychiatric disorders have been reported in up to 50%of chronic HCV infected patients.Both the central and peripheral nervous system may be involved with a wide variety of clinical manifestations.Main HCV-associated neurological conditions include cerebrovascular events,encephalopathy,myelitis,encephalomyelitis,and cognitive impairment,whereas'brain fog',depression,anxiety,and fatigue are at the top of the list of psychiatric disorders.Moreover,HCV infection is known to cause both motor and sensory peripheral neuropathy in the context of mixed cryoglobulinemia,and has also been recently recognized as an independent risk factor for stroke.These extrahepatic manifestations are independent of severity of the underlying chronic liver disease and hepatic encephalopathy.The brain is a suitable site for HCV replication,where the virus may directly exert neurotoxicity;other mechanisms proposed to explain the pathogenesis of neuropsychiatric disorders in chronic HCV infection include derangement of metabolic pathways of infected cells,alterations in neurotransmitter circuits,autoimmune disorders,and cerebral or systemic inflammation.A pathogenic role for HCV is also suggested by improvement of neurological and psychiatric symptoms in patients achieving a sustained virologic response following interferon treatment;however,further ad hoc trials are needed to fully assess the impact of HCV infection and specific antiviral treatments on associated neuropsychiatric disorders.Luigi Elio Adinolfi Riccardo Nevola Giacomo Lus Luciano Restivo Barbara Guerrera Ciro Romano Rosa Zampino Luca Rinaldi Ausilia Sellitto Mauro Giordano Aldo Marrone 2015World Journal of Gastroenterology2015,21,8:6
7Chronic hepatitis C virus infection and atherosclerosis: Clinical impact and mechanisms显示文摘Hepatitis C virus(HCV)infection represents a major health issue worldwide due to its burden of chronic liver disease and extrahepatic manifestations including cardiovascular diseases,which are associated with excess mortality.Analysis of published studies supports the view that HCV infection should be considered a risk factor for the development of carotid atherosclerosis,heart failure and stroke.In contrast,findings from studies addressing coronary artery disease and HCV have yielded conflicting results.Therefore,meta-analytic reviews and prospective studies are warranted.The pathogenic mechanisms connecting HCV infection,chronic liver disease,and atherogenesis are not completely understood.However,it has been hypothesized that HCV may promote atherogenesis and its complications through several direct and indirect biological mechanisms involving HCV colonization and replication within arterial walls,liver steatosis and fibrosis,enhanced and imbalanced secretion of inflammatory cytokines,oxidative stress,endotoxemia,mixed cryoglobulinemia,perturbed cellular and humoral immunity,hyperhomocysteinemia,hypo-adiponectinaemia,insulin resistance,type 2 diabetes and other components of the metabolic syndrome.Understanding these complex mechanisms is of fundamental importance for the development of novel therapeutic approaches to prevent and to treat vascular complications in patients with chronic HCV infection.Currently,it seems that HCV clearance by interferon and ribavirin treatment significantly reduces non-liver-related mortality;moreover,interferon-based treatment appears to decrease the risk of ischemic stroke.Luigi E Adinolfi Rosa Zampino Luciano Restivo Amedeo Lonardo Barbara Guerrera Aldo Marrone Fabio Nascimbeni Anna Florio Paola Loria 2014World Journal of Gastroenterology2014,20,13:6
8Predictors of early and late hepatocellular carcinoma recurrence显示文摘Hepatocellular carcinoma(HCC)is the most frequent liver neoplasm,and its incidence rates are constantly increasing.Despite the availability of potentially curative treatments(liver transplantation,surgical resection,thermal ablation),long-term outcomes are affected by a high recurrence rate(up to 70%of cases 5 years after treatment).HCC recurrence within 2 years of treatment is defined as“early”and is generally caused by the occult intrahepatic spread of the primary neoplasm and related to the tumor burden.A recurrence that occurs after 2 years of treatment is defined as“late”and is related to de novo HCC,independent of the primary neoplasm.Early HCC recurrence has a significantly poorer prognosis and outcome than late recurrence.Different pathogenesis corresponds to different predictors of the risk of early or late recurrence.An adequate knowledge of predictive factors and recurrence risk stratification guides the therapeutic strategy and post-treatment surveillance.Patients at high risk of HCC recurrence should be referred to treatments with the lowest recurrence rate and when standardized to combined or adjuvant therapy regimens.This review aimed to expose the recurrence predictors and examine the differences between predictors of early and late recurrence.Riccardo Nevola Rachele Ruocco Livio Criscuolo Angela Villani Maria Alfano Domenico Beccia Simona Imbriani Ernesto Claar Domenico Cozzolino Ferdinando Carlo Sasso Aldo Marrone Luigi Elio Adinolfi Luca Rinaldi 2023World Journal of Gastroenterology2023,29,8:6
9Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease显示文摘BACKGROUND In non-alcoholic fatty liver disease(NAFLD), a high-fat or high-fructose diet increases intestinal permeability and promotes derangement of the gut-liver axis.We hypothesize that, diet could be able to modulate intestinal permeability in patients with NAFLD.AIM To detect diet-induced modification of intestinal permeability in patients with NAFLD undergoing a Mediterranean diet or a low-fat diet.METHODS The current study was a dietary intervention for non-diabetic, patients with biopsy-verified NAFLD and increased transaminases. A crossover design was employed: participants underwent 16 weeks of Mediterranean diet, 16 wk of free wash-out, and 16 weeks of low-fat diet. Both diets were hypocaloric and no consumption of supplements was allowed. All patients were followed bimonthly by a dietitian. Evaluations of clinical and metabolic parameters were completed at baseline and at the end of each dietary period. Intestinal permeability was assessed by chromium-51 ethylene diamine tetraacetate excretion testing(51 CrEDTA).RESULTS Twenty Caucasian patients, 90% male, median age 43 years, body mass index(BMI) 30.9, with biopsy-verified NAFLD were enrolled. At the end of 16 weeks of a Mediterranean diet, a significant reduction in mean body weight(-5.3 ± 4.1 kg,P = 0.003), mean waist circumference(-7.9 ± 4.9 cm, P = 0.001), and mean transaminase levels [alanine aminotransferase(ALT)-28.3 ± 11.9 IU/L, P =0.0001; aspartate aminotransferase(AST)-6.4 ± 56.3 IU/L, P = 0.01] were observed. These benefits were maintained after 16 wk of wash-out and also after16 wk of low-fat diet, without further improvements. Fourteen of the 20 patients had intestinal permeability alteration at baseline(mean percentage retention of51 Cr-EDTA = 5.4%), but no significant changes in intestinal permeability were observed at the end of the 16 wk of the Mediterranean diet or 16 wk of the low-fat diet.CONCLUSION Mediterranean diet is an effective strategy for treating overweight, visceral obesity and serum transaminase in patients with NAFLD. If the Mediterranean diet can improve intestinal permeability in patients with NAFLD, it deserves further investigation.Marco Biolato Fiorella Manca Giuseppe Marrone Consuelo Cefalo Simona Racco Giacinto A Miggiano Venanzio Valenza Antonio Gasbarrini Luca Miele Antonio Grieco 2019World Journal of Gastroenterology2019,25,4:4
10Abdominal fat interacts with PNPLA 3 I148M, but not with the APOC 3 variant in the pathogenesis of liver steatosis in chronic hepatitis C显示文摘R. Zampino N. Coppola G. Cirillo A. Boemio M. Pisaturo A. Marrone M. Macera E. Sagnelli L. Perrone L. E. Adinolfi E. Miraglia del Giudice 2013J Viral Hepat2013,,8:3
11TM 6 SF 2 E167K variant is associated with severe steatosis in chronic hepatitis C, regardless of PNPLA 3 polymorphism显示文摘Nicola Coppola Zampino Rosa Grazia Cirillo Maria Stanzione Margherita Macera Adriana Boemio Anna Grandone Mariantonietta Pisaturo Aldo Marrone Luigi E. Adinolfi Evangelista Sagnelli Emanuele Miraglia del Giudice 2015Liver Int2015,,8:3
12Role of interleukin 28-B in the spontaneous and treatment-related clearance of HCV infection in patients with chronic HBV/HCV dual infection显示文摘N. Coppola A. Marrone M. Pisaturo M. Starace G. Signoriello I. Gentile L. E. Adinolfi E. Sagnelli R. Zampino 2014European Journal of Clinical Microbiology & Infectious Diseases2014,,4:3
13Abdominal fat interacts with PNPLA 3 I148M, but not with the APOC 3 variant in the pathogenesis of liver steatosis in chronic hepatitis C显示文摘R. Zampino N. Coppola G. Cirillo A. Boemio M. Pisaturo A. Marrone M. Macera E. Sagnelli L. Perrone L. E. Adinolfi E. Miraglia del Giudice 2013J Viral Hepat2013,,8:3
14Direct oral anticoagulant administration in cirrhotic patients with portal vein thrombosis:What is the evidence?显示文摘In recent years,the traditional concept that cirrhosis-related coagulopathy is an acquired bleeding disorder has evolved.Currently,it is known that in cirrhotic patients,the hemostatic system is rebalanced,which involves coagulation factors,fibrinolysis and platelets.These alterations disrupt homeostasis,skewing it toward a procoagulant state,which can lead to thromboembolic manifestations,especially when hemodynamic and endothelial factors co-occur,such as in the portal vein system in cirrhosis.Portal vein thrombosis is a common complication of advanced liver cirrhosis that negatively affects the course of liver disease,prognosis of cirrhotic patients and success of liver transplantation.It is still debated whether portal vein thrombosis is the cause or the consequence of worsening liver function.Anticoagulant therapy is the mainstay treatment for acute symptomatic portal vein thrombosis.In chronic portal vein thrombosis,the role of anticoagulant therapy is still unclear.Traditional anticoagulants,vitamin K antagonists and low-molecular-weight heparin are standard-of-care treatments for portal vein thrombosis.In the last ten years,direct oral anticoagulants have been approved for the prophylaxis and treatment of many thromboembolicrelated diseases,but evidence on their use in cirrhotic patients is very limited.The aim of this review was to summarize the evidence about the safety and effectiveness of direct oral anticoagulants for treating portal vein thrombosis in cirrhotic patients.Marco Biolato Mattia Paratore Luca Di Gialleonardo Giuseppe Marrone Antonio Grieco 2022World Journal of Hepatology2022,14,4:2
15Association Between a Polymorphism in Cannabinoid Receptor 2 and Severe Necroinflammation in Patients With Chronic Hepatitis C显示文摘Nicola Coppola Rosa Zampino Giulia Bellini Margherita Macera Aldo Marrone Mariantonietta Pisaturo Adriana Boemio Bruno Nobili Giuseppe Pasquale Sabatino Maione Luigi Elio Adinolfi Laura Perrone Evangelista Sagnelli Emanuele Miraglia Del Giudice Francesca 2013Clinical Gastroenterology and Hepatology2013,,:2
16神经生长因子增强小胶质细胞的神经保护作用显示文摘小胶质细胞是脑组织内的防御细胞,但在病理和生理条件下,调控小胶质细胞活化的因子并不十分清楚。本研究发现,神经生长因子(NGF)可以增强小胶质细胞的神经保护和抗炎功能。在体内和体外研究中都发现,小胶质细胞表达NGF受体。原代培养小胶质细胞,给予NGF处理,转录本分析结果显示,NGF对小胶质细胞的运动、吞噬和降解吞噬物的能力均产生影响。对功能的研究显示,NGF可增加小胶质细胞的膜运动能力和胞饮作用;在体研究显示,NGF可激活小胶质细胞释放向外整流电流,调节周围谷氨酸能神经元的神经传递。既往研究提示,小胶质细胞有清除脑内Aβ肽的功能,本研究观察了NGF对小胶质细胞吞噬能力的影响。结果显示,NGF可促进小胶质细胞通过Trk A途径清除Aβ,并加速其降解。此外,NGF还可减轻由Aβ导致的炎症激活。特异性激活小胶质细胞还可以减轻由Aβ导致的神经元树突损伤和长时程增强抑制。在对离体脑片的研究中,我们也发现NGF可以促进小胶质细胞吞噬Aβ。综上所述,本研究证实NGF可以促进小胶质细胞活化,活化的小胶质细胞通过抗炎作用减轻Aβ聚集,发挥神经保护作用。唐颖馨 Rizzi C Tiberi A Giustizieri M Marrone MC Gobbo F Carucci NM Meli G Arisi I D'Onofrio M Marinelli S Capsoni S Cattaneo A 2018神经损伤与功能重建2018,13,2:2
17Insulin resistance and steatosis in HBV-HCV co-infected patients: Role of PNPLA3 polymorphisms and impact on liver fibrosis progression显示文摘AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected patients.METHODS:Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled:66 had HBV-HCV,66 HBV and 198 HCV infection.Prevalence of steatosis,IR and PNPLA3 polymorphisms and their relation to anthropometric,biochemical,virological and histological parameters were evaluated.RESULTS:Prevalence of steatosis in group HBV-HCV was similar to that in HCV(47.0% vs 49.5%,respec-tively);group HBV showed the lowest steatosis(33.3%).Group HBV-HCV had a lesser degree of steatosis than HCV(P = 0.016),lower HCV RNA levels(P = 0.025) and lower prevalence and degree of IR(P = 0.01).PNPLA3 polymorphisms were associated with steatosis.Group HBV-HCV showed higher levels of liver fibrosis than group HCV(P = 0.001),but similar to that ob-served in HBV group.In HBV-HCV group,liver fibrosis was not associated with steatosis,IR or PNPLA3.HBV infection was the independent predictor of advanced liver fibrosis.CONCLUSION:HBV-HCV co-infected patients have lower degree of hepatic steatosis,IR and HCV RNA than HCV mono-infected;co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.Rosa Zampino Adriana Boemio Aldo Marrone Luciano Restivo Maria Chiara Fascione Riccardo Nevola Luigi Elio Adinolfi Nicola Coppola Carmine Minichini Mario Starace Evangelista Sagnelli Grazia Cirillo Emanuele Miraglia del Giudice Maria Stanzione Emanuele Durante-Mangoni Giovanna Salzillo 2014World Journal of Hepatology2014,6,9:2
18Percutaneous transarterial embolization of extrahepatic arteroportal fistula显示文摘Arteroportal fi stula is a rare cause of prehepatic portal hypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding. Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the color- Doppler by a turbulent ? ow, and arterialization of portal vein ? ow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confi rming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed. Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension.Gianluca Marrone Settimo Caruso Roberto Miraglia Ilaria Tarantino Riccardo Volpes Angelo Luca 2006World Journal of Gastroenterology2006,12,34:2
19Interplay between oxidative stress and hepatic steatosis in the progression of chronic hepatitis C显示文摘Matteo Vidali Marie-Francoise Tripodi Alesandra Ivaldi Rosa Zampino Giuseppa Occhino Luciano Restivo Salvatore Sutti Aldo Marrone Giuseppe Ruggiero Emanuele Albano Luigi E. Adinolfi 2007Journal of Hepatology2007,,3:2
20The cardiovascular effects of obstructive sleep epneeas:analysis of pathogenic mechanisms显示文摘Bonsignore M R Marrone O Insalaco G 1994Eur Respir J1994,7,:1
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