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| 1 | Portal vein thrombosis:Insight into physiopathology,diagnosis,and treatment显示文摘Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but might also occur in absence of an overt liver disease. Several causes, either local or systemic, might play an important role in PVT pathogenesis. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Clinical examination, laboratory investigations, and imaging are helpful to provide a quick diagnosis, as prompt treatment might greatly affect a patient's outcome. In this review, we analyze the physiopathological mechanisms of PVT development, together with the hemodynamic and functional alterations related to this condition. Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures. Finally, we analyze the implications of PVT in the setting of liver transplantation and its possible influence on patients' future prognoses. | Francesca R Ponziani Maria A Zocco Chiara Campanale Emanuele Rinninella Annalisa Tortora Luca Di Maurizio Giuseppe Bombardieri Raimondo De Cristofaro Anna M De Gaetano Raffaele Landolfi Antonio Gasbarrini | 2010 | World Journal of Gastroenterology2010，16，2： | 75 |
| 2 | Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation显示文摘Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).The most used treatments include transarterial chemoembolization and radiofrequency ablation.Surgical resection has also been successfully used as a bridging procedure,and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function.The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation,reducing HCC recurrence after transplantation,and improving post-transplant overall survival.To date,no data from prospective randomized studies are available;however,for HCC patients listed for LT within the Milan criteria,prolonging the waiting time over 6-12 mo is a risk factor for tumor spread.Bridging treatments are useful in containing tumor progression and decreasing dropout.Furthermore,the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT.Lastly,although a definitive conclusion can not be reached,the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival.Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT.Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging. | Maurizio Pompili Giampiero Francica Francesca Romana Ponziani Roberto Iezzi Alfonso Wolfango Avolio | 2013 | World Journal of Gastroenterology2013，19，43： | 24 |
| 3 | What we should know about portal vein thrombosis in cirrhotic patients:A changing perspective显示文摘Portal vein thrombosis(PVT) is one of the most common complications occurring during the natural course of liver cirrhosis.Even though PVT is often asymptomatic,the worsening of liver function,an unexpected episode of gastrointestinal bleeding or ascitic decompensation may be landmarks of PVT development.Beyond these clinical manifestations,it is debated whether PVT really has an impact on liver cirrhosis natural history or rather represents only one of its consequences.Probably PVT development should not only be considered as a matter of impaired blood flow or pro-coagulation tendency.On one hand,PVT seems a consequence of the worsening in portal vein outflow due to the increased hepatic resistance in cirrhotic livers.On the other hand,vascular microthrombosis secondary to necroinflammation may cause liver ischemia and infarction,with loss of hepatic tissue(parenchymal extinction) which is replaced by fibrotic tissue.Therefore,PVT might also be considered as the overt manifestation of the liver fibrosing process evolution and anticoagulant therapy may thus have microscopic indirect effects also on the progression of liver disease.At present,a connection between PVT development and the progression of liver fibrosis/cirrhosis has not yet been demonstrated.Nevertheless,it is not clear if PVT development may worsen cirrhotic patients' outcome by itself.Some authors tried to assess liver transplant benefit in PVT cirrhotic patients but data are contrasting.In this review,we will try to answer these questions,providing a critical analysis of data reported in literature. | Francesca Romana Ponziani Maria Assunta Zocco Matteo Garcovich Francesca D'Aversa Davide Roccarina Antonio Gasbarrini | 2012 | World Journal of Gastroenterology2012，18，36： | 24 |
| 4 | Portal vein thrombosis in cirrhosis: Why a well-known complication is still matter of debate显示文摘Portal vein thrombosis(PVT)represents a well-known complication during the natural course of liver cirrhosis(LC),ranging from asymptomatic cases to lifethreating conditions related to portal hypertension and hepatic decompensation.Portal flow stasis,complex acquired hypercoagulable disorders and exogenous factors leading to endothelial dysfunction have emerged as key factors for PVT development.However,PVT occurrence remains unpredictable and many issues regarding its natural history,prognostic significance and treatment are still elusive.In particular although spontaneous resolution or disease stability occur in most cases of PVT,factors predisposing to disease progression or recurrence after spontaneous recanalization are not clarified as yet.Moreover,PVT impact on LC outcome is still debated,as PVT may represent itself a consequence of liver fibrosis and hepatic dysfunction progression.Anticoagulation and transjugular intrahepatic portosystemic shunt are considered safe and effective in this setting and are recommended in selected cases,even if the safer therapeutic option and the optimal therapy duration are still unknown.Nevertheless,their impact on mortality rates should be addressed more extensively.In this review we present the most debated questions regarding PVT,whose answers should come from prospective cohort studies and large sample-size randomized trials. | Mariella Faccia Maria Elena Ainora Francesca Romana Ponziani Laura Riccardi Matteo Garcovich Antonio Gasbarrini Maurizio Pompili Maria Assunta Zocco | 2019 | World Journal of Gastroenterology2019，25，31： | 23 |
| 5 | Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers显示文摘Hepatocellular carcinoma is one of the most frequent malignant tumors worldwide:Portal vein tumor thrombosis(PVTT)occurs in about 35%-50%of patients and represents a strong negative prognostic factor,due to the increased risk of tumor spread into the bloodstream,leading to a high recurrence risk.For this reason,it is a contraindication to liver transplantation and in several prognostic scores sorafenib represents its standard of care,due to its antiangiogenetic action,although it can grant only a poor prolongation of life expectancy.Recent scientific evidences lead to consider PVTT as a complex anatomical and clinical condition,including a wide range of patients with different prognosis and new treatment possibilities according to the degree of portal system involvement,tumor biological aggressiveness,complications caused by portal hypertension,patient’s clinical features and tolerance to antineoplastic treatments.The median survival has been reported to range between 2.7 and 4 mo in absence of therapy,but it can vary from 5 mo to 5 years,thus depicting an extremely variable scenario.For this reason,it is extremely important to focus on the most adequate strategy to be applied to each group of PVTT patients. | Lucia Cerrito Brigida Eleonora Annicchiarico Roberto Iezzi Antonio Gasbarrini Maurizio Pompili Francesca Romana Ponziani | 2019 | World Journal of Gastroenterology2019，25，31： | 21 |
| 6 | Intestinal 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 | 2019 | World Journal of Gastroenterology2019，25，33： | 19 |
| 7 | Eubiotic properties of rifaximin: Disruption of the traditional concepts in gut microbiota modulation显示文摘Antibiotics are usually prescribed to cure infections but they also have significant modulatory effects on the gut microbiota. Several alterations of the intestinal bacterial community have been reported during antibiotic treatment, including the reduction of beneficial bacteria as well as of microbial alpha-diversity. Although after the discontinuation of antibiotic therapies it has been observed a trend towards the restoration of the original condition, the new steady state is different from the previous one, as if antibiotics induced some kind of irreversible perturbation of the gut microbial community. The poorly absorbed antibiotic rifaximin seem to be different from the other antibiotics, because it exerts non-traditional effects additional to the bactericidal/bacteriostatic activity on the gut microbiota. Rifaximin is able to reduce bacterial virulence and translocation, has anti-inflammatory properties and has been demonstrated to positively modulate the gut microbial composition. Animal models, culture studies and metagenomic analyses have demonstrated an increase in Bifidobacterium, Faecalibacterium prausnitzii and Lactobacillus abundance after rifaximin treatment, probably consequent to the induction of bacterial resistance, with no major change in the overall gut microbiota composition. Antibiotics are therefore modulators of the symbiotic relationship between the host and the gut microbiota. Specific antibiotics, such as rifaximin, can also induce eubiotic changes in the intestinal ecosystem; this additional property may represent a therapeutic advantage in specific clinical settings. | Francesca Romana Ponziani Maria Assunta Zocco Francesca D’Aversa Maurizio Pompili Antonio Gasbarrini | 2017 | World Journal of Gastroenterology2017，23，25： | 17 |
| 8 | Prevention and treatment of hepatic encephalopathy: Focusing on gut microbiota显示文摘The gut flora plays an important role in the pathogenesis of the complications of cirrhosis. Hepatic encephalopathy (HE) represents a broad continuum of neuropsychological dysfunction in patients with acute or chronic liver disease and/or porto-systemic shunting of blood flow and it manifests with progressive deterioration of the superior neurological functions. The pathophysiology of this disease is complex, as it involves overproduction and reduced metabolism of various neurotoxins, particularly ammonia. Management of HE is diversified and requires several steps: elimination of precipitating factors, removal of toxins, proper nutritional support, modulation of resident fecal flora and downregulation of systemic and gut-derived inflammation. This review will provide an overview of gut barrier function and the influence of gut-derived factors on HE, focusing on the role of gut microbiota in the pathogenesis of HE and the recent literature findings on its therapeutic manipulation. | Matteo Garcovich Maria Assunta Zocco Davide Roccarina Francesca Romana Ponziani Antonio Gasbarrini | 2012 | World Journal of Gastroenterology2012，18，46： | 16 |
| 9 | Effect of rifaximin on gut microbiota composition in advanced liver disease and its complications显示文摘Liver cirrhosis is a paradigm of intestinal dysbiosis. The qualitative and quantitative derangement of intestinal microbial community reported in cirrhotic patients seems to be strictly related with the impairment of liver function. A kind of gut microbial 'fingerprint',characterized by the reduced ratio of 'good' to 'potentially pathogenic' bacteria has recently been outlined,and is associated with the increase in Model for End-Stage Liver Disease and Child Pugh scores. Moreover,in patients presenting with cirrhosis complications such as spontaneous bacterial peritonitis(SBP),hepatic encephalopathy(HE),and,portal hypertension intestinal microbiota modifications or the isolation of bacteria deriving from the gut are commonly reported. Rifaximin is a non-absorbable antibiotic used in the management of several gastrointestinal diseases. Beyond bactericidal/bacteriostatic,immune-modulating and anti-inflammatory activity,a little is known about its interaction with gut microbial environment. Rifaximin has been demonstrated to exert beneficial effects on cognitive function in patients with HE,and also to prevent the development of SBP,to reduce endotoxemia and to improve hemodynamics in cirrhotics. These results are linked to a shift in gut microbes functionality,triggering the production of favorable metabolites. The low incidence of drug-related adverse events due to the small amount of circulating drug makes rifaximin a relatively safe antibiotic for the modulation of gut microbiota in advanced liver disease. | Francesca Romana Ponziani Viviana Gerardi Silvia Pecere Francesca D'Aversa Loris Lopetuso Maria Assunta Zocco Maurizio Pompili | 2015 | World Journal of Gastroenterology2015，21，43： | 16 |
| 10 | Subclinical atherosclerosis is linked to small intestinal bacterial overgrowth via vitamin K2-dependent mechanisms显示文摘AIM To assess the rate of matrix Gla-protein carboxylation in patients with small intestinal bacterial overgrowth(SIBO) and to decipher its association with subclinical atherosclerosis.METHODS Patients with suspected SIBO who presented with a low risk for cardiovascular disease and showed no evidence of atherosclerotic plaques were included in the study. A glucose breath test was performed in order to confirm the diagnosis of SIBO and vascular assessment was carried out by ultrasound examination. Plasma levels of the inactive form of MGP(dephosphorylateduncarboxylated matrix Gla-protein) were quantified by ELISA and vitamin K2 intake was estimated using a food frequency questionnaire.RESULTS Thirty-nine patients were included in the study. SIBO was confirmed in 12/39(30.8%) patients who also presented with a higher concentration ofdephosphorylated-uncarboxylated matrix Gla-protein(9.5 μg/L vs 4.2 μg/L; P = 0.004). Arterial stiffness was elevated in the SIBO group(pulse-wave velocity 10.25 m/s vs 7.68 m/s; P = 0.002) and this phenomenon was observed to correlate linearly with the levels of dephosphorylated-uncarboxylated matrix Gla-protein(β = 0.220, R2 = 0.366, P = 0.03). Carotid intima-media thickness and arterial calcifications were not observed to be significantly elevated as compared to controls.CONCLUSION SIBO is associated with reduced matrix Gla-protein activation as well as arterial stiffening. Both these observations are regarded as important indicators of subclinical atherosclerosis. Hence, screening for SIBO, intestinal decontamination and supplementation with vitamin K2 has the potential to be incorporated into clinical practice as additional preventive measures. | Francesca Romana Ponziani Maurizio Pompili Enrico Di Stasio Maria Assunta Zocco Antonio Gasbarrini Roberto Flore | 2017 | World Journal of Gastroenterology2017，23，7： | 9 |
| 11 | Diagnosis of bowel diseases:The role of imaging and ultrasonography显示文摘Examinations with a visualisation of the anatomy and pathology of the gastrointestinal(GI) tract are often necessary for the diagnosis of GI diseases.Traditional radiology played a crucial role for many years.Endoscopy,despite some limitations,remains the main technique in the differential diagnosis and treatment of GI diseases.In the last decades,the introduction of,and advances in,non-invasive cross-sectional imaging modalities,including ultrasound(US),computed tomography(CT),positron-emission tomography(PET),and magnetic resonance imaging,as well as improvements in the resolution of imaging data,the acquisition of 3D images,and the introduction of contrast-enhancement,have modified the approach to the examination of the GI tract.Moreover,additional co-registration techniques,such as PET-CT and PET-MRI,allow multimodal data acquisition with better sensitivity and specificity in the study of tissue pathology.US has had a growing role in the development and application of the techniques for diagnosis and management of GI diseases because it is inexpensive,non-invasive,and more comfortable for the patient,and it has sufficient diagnostic accuracy toprovide the clinician with image data of high temporal and spatial resolution.Moreover,Doppler and contrastenhanced ultrasound(CEUS) add important information about blood flow.This article provides a general review of the current literature regarding imaging modalities used for the evaluation of bowel diseases,highlighting the role of US and recent developments in CEUS. | Davide Roccarina Matteo Garcovich Maria Elena Ainora Gianluigi Caracciolo Francesca Ponziani Antonio Gasbarrini Maria Assunta Zocco | 2013 | World Journal of Gastroenterology2013，19，14： | 5 |
| 12 | Thrombotic risk factors in patients with liver cirrhosis: Correlation with MELD scoring system and portal vein thrombosis development显示文摘 | Maria Assunta Zocco Enrico Di Stasio Raimondo De Cristofaro Marialuisa Novi Maria Elena Ainora Francesca Ponziani Laura Riccardi Stefano Lancellotti Angelo Santoliquido Roberto Flore Maurizio Pompili Gian Lodovico Rapaccini Paolo Tondi Giovanni Battista G | 2009 | Journal of Hepatology2009，，4： | 5 |
| 13 | Viral hepatitis and hepatocellular carcinoma:From molecular pathways to the role of clinical surveillance and antiviral treatment显示文摘Hepatocellular carcinoma(HCC)is a global health challenge.Due to the high prevalence in low-income countries,hepatitis B virus(HBV)and hepatitis C virus infections remain the main risk factors for HCC occurrence,despite the increasing frequencies of non-viral etiologies.In addition,hepatitis D virus coinfection increases the oncogenic risk in patients with HBV infection.The molecular processes underlying HCC development are complex and various,either independent from liver disease etiology or etiology-related.The reciprocal interlinkage among non-viral and viral risk factors,the damaged cellular microenvironment,the dysregulation of the immune system and the alteration of gutliver-axis are known to participate in liver cancer induction and progression.Oncogenic mechanisms and pathways change throughout the natural history of viral hepatitis with the worsening of liver fibrosis.The high risk of cancer incidence in chronic viral hepatitis infected patients compared to other liver disease etiologies makes it necessary to implement a proper surveillance,both through clinical-biochemical scores and periodic ultrasound assessment.This review aims to outline viral and microenvironmental factors contributing to HCC occurrence in patients with chronic viral hepatitis and to point out the importance of surveillance programs recommended by international guidelines to promote early diagnosis of HCC. | Leonardo Stella Francesco Santopaolo Antonio Gasbarrini Maurizio Pompili Francesca Romana Ponziani | 2022 | World Journal of Gastroenterology2022，28，21： | 4 |
| 14 | Future of liver disease in the era of direct acting antivirals for the treatment of hepatitis C显示文摘Hepatitis C virus(HCV) infection has been a global health problem for decades, due to the high number of infected people and to the lack of effective and welltolerated therapies. In the last 3 years, the approval of new direct acting antivirals characterized by high rates of virological clearance and excellent tolerability has dramatically improved HCV infection curability, especially for patients with advanced liver disease and for liver transplant recipients. Long-term data about the impact of the new direct acting antivirals on liver fibrosis and liver disease-related outcomes are not yet available, due to their recent introduction. However, previously published data deriving from the use of pegylatedinterferon and ribavirin lead to hypothesizing that we are going to observe, in the future, a reduction in mortality and in the incidence of hepatocellular carcinoma, as well as a regression of fibrosis for people previously affected by hepatitis C. In the liver transplant setting, clinical improvement has already been described after treatment with the new direct acting antivirals, which has often led to patients delisting. In the future, this may hopefully reduce the gap between liver organ request and availability, probably expanding liver transplant indications to other clinical conditions. Therefore, these new drugs are going to change the natural history of HCV-related liver disease and the epidemiology of HCV infection worldwide. However, the global consequences will depend on treatment accessibility and on the number of countries that could afford the use of the new direct acting antivirals. | Francesca Romana Ponziani Francesca Mangiola Cecilia Binda Maria Assunta Zocco Massimo Siciliano Antonio Grieco Gian Lodovico Rapaccini Maurizio Pompili Antonio Gasbarrini | 2017 | World Journal of Hepatology2017，9，7： | 3 |
| 15 | Thrombotic risk factors in patients with liver cirrhosis: Correlation with MELD scoring system and portal vein thrombosis development显示文摘 | Maria Assunta Zocco Enrico Di Stasio Raimondo De Cristofaro Marialuisa Novi Maria Elena Ainora Francesca Ponziani Laura Riccardi Stefano Lancellotti Angelo Santoliquido Roberto Flore Maurizio Pompili Gian Lodovico Rapaccini Paolo Tondi Giovanni Battista G | 2009 | Journal of Hepatology2009，，4： | 2 |
| 16 | Portal vein thrombosis and liver transplantation: Implications for waiting list period, surgical approach, Early and late follow-up显示文摘 | Francesca Romana Ponziani Maria Assunta Zocco Marco Senzolo Maurizio Pompili Antonio Gasbarrini Alfonso Wolfango Avolio | 2014 | Transplantation Reviews2014，，： | 2 |
| 17 | Hypermethylation of CXCR4 promoter in CD34^+ cells from patients with primary myelofibrosis 显示文摘 | Bogani C Ponziani V Guglielmelli P | 2008 | Stem Cells2008，26，8： | 1 |
| 18 | Cognitive dysfunction in early-onset multiple sclerosis: a reappraisal after 10 years 显示文摘 | Amato MP Ponziani G Siracusa G | 2001 | Arch Neurol2001，58，10： | 1 |
| 19 | Gut microbiota and metabolic syndrome显示文摘 | Francesca D’Aversa Annalisa Tortora Gianluca Ianiro Francesca Romana Ponziani Brigida Eleonora Annicchiarico Antonio Gasbarrini | 2013 | Internal and Emergency Medicine2013，，1： | 1 |
| 20 | Early prediction of response to Sorafenib in patients with advanced hepatocellular carcinoma: the role of dynamic contrast enhanced ultrasound显示文摘 | Zocco Maria Assunta Garcovich Matteo Lupascu Andrea Di Stasio Enrico Roccarina Davide Annicchiarico Brigida Elenora Riccardi Laura Ainora Maria Elena Ponziani Francesca Caracciolo Gianluigi Rapaccini Gian Lodovico Landolfi Raffaele Siciliano Massimo Pompi | 2013 | Journal of Hepatology2013，，： | 1 |
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