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| 1 | Endoscopic treatment of esophageal varices in patients with liver cirrhosis显示文摘Variceal bleeding is a life-threatening complication of portal hypertension with a six-week mortality rate of approximately 20%. Patients with medium- or largesized varices can be treated for primary prophylaxis of variceal bleeding using two strategies: non-selective beta-blockers(NSBBs) or endoscopic variceal ligation(EVL). Both treatments are equally effective. Patients with acute variceal bleeding are critically ill patients. The available data suggest that vasoactive drugs, combined with endoscopic therapy and antibiotics, are the best treatment strategy with EVL being the endoscopic procedure of choice. In cases of uncontrolled bleeding, transjugular intrahepatic portosystemic shunt(TIPS) with polytetrafluoroethylene(PTFE)-covered stents are recommended. Approximately 60% of the patients experience rebleeding, with a mortality rate of 30%. Secondary prophylaxis should start on day six following the initial bleeding episode. The combination of NSBBs and EVL is the recommended management, whereas TIPS with PTFE-covered stents are the preferred option in patients who fail endoscopic and pharmacologic treatment. Apart from injection sclerotherapy and EVL, other endoscopic procedures, including tissue adhesives, endoloops, endoscopic clipping and argon plasma coagulation, have been used in the management of esophageal varices. However, their efficacy and safety, compared to standard endoscopic treatment, remain to be further elucidated. There are safety issues accompanying endoscopic techniques with aspiration pneumonia occurring at a rate of approximately 2.5%. In conclusion, future research is needed to improve treatment strategies, including novel endoscopic techniques with better efficacy, lower cost, and fewer adverse events. | Christos Triantos Maria Kalafateli | 2014 | World Journal of Gastroenterology2014，20，36： | 53 |
| 2 | Recurrence of choledocholithiasis following endoscopic bile duct clearance: Long term results and factors associated with recurrent bile duct stones显示文摘AIM To evaluate the rate of recurrence of symptomatic chol-edocholithiasis and identify factors associated with the recurrence of bile duct stones in patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy(EST) for bile duct stone disease.METHODS All patients who underwent ERCP and EST for bile duct stone disease and had their bile duct cleared from 1/1/2005 until 31/12/2008 was enrolled. All symptomatic recurrences during the study period(until 31/12/2015) were recorded. Clinical and laboratory data potentially associated with common bile duct(CBD) stone recurrence were retrospectively retrieved from patients' files.RESULTS A total of 495 patients were included. Sixty seven(67) out of 495 patients(13.5%) presented with recurrent symptomatic choledocholithiasis after 35.28 ± 16.9 mo while twenty two(22) of these patients(32.8%) experienced a second recurrence after 35.19 ± 23.2 mo. Factors associated with recurrence were size(diameter) of the largest CBD stone found at first presentation(10.2 ± 6.9 mm vs 7.2 ± 4.1 mm, P = 0.024), diameter of the CBD at the first examination(15.5 ± 6.3 mm vs 12.0 ± 4.6 mm, P = 0.005), use of mechanical lithotripsy(ML)(P = 0.04) and presence of difficult lithiasis(P = 0.04). Periampullary diverticula showed a trend towards significance(P = 0.066). On the contrary, number of stones, angulation of the CBD, number of ERCP sessions required to clear the CBD at first presentation, more than one ERCP session needed to clear the bile duct initially and a gallbladder in situ did not influence recurrence. CONCLUSION Bile duct stone recurrence is a possible late complication following endoscopic stone extraction and CBD clearance. It appears to be associated with anatomical parameters(CBD diameter) and stone characteristics(stone size, use of ML, difficult lithiasis) at first presentation. | Christos Konstantakis Christos Triantos Vasileios Theopistos Georgios Theocharis Ioannis Maroulis Georgia Diamantopoulou Konstantinos Thomopoulos | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，1： | 46 |
| 3 | Role of NLRP3 inflammasome in inflammatory bowel diseases显示文摘Inflammasomes are multiprotein intracellular complexes which are responsible for the activation of inflammatory responses. Among various subtypes of inflammasomes, NLRP3 has been a subject of intensive investigation. NLRP3 is considered to be a sensor of microbial and other danger signals and plays a crucial role in mucosal immune responses, promoting the maturation of proinflammatory cytokines interleukin 1β(IL-1β) and IL-18. NLRP3 inflammasome has been associated with a variety of inflammatory and autoimmune conditions, including inflammatory bowel diseases(IBD). The role of NLRP3 in IBD is not yet fully elucidated as it seems to demonstrate both pathogenic and protective effects. Studies have shown a relationship between genetic variants and mutations in NLRP3 gene with IBD pathogenesis. A complex interaction between the NLRP3 inflammasome and the mucosal immune response has been reported. Activation of the inflammasome is a key function mediated by the innate immune response and in parallel the signaling through IL-1β and IL-18 is implicated in adaptive immunity. Further research is needed to delineate the precise mechanisms of NLRP3 function in regulating immune responses. Targeting NLRP3 inflammasome and its downstream signaling will provide new insights into the development of future therapeutic strategies. | Evanthia Tourkochristou Ioanna Aggeletopoulou Christos Konstantakis Christos Triantos | 2019 | World Journal of Gastroenterology2019，25，33： | 24 |
| 4 | Role of band ligation for secondary prophylaxis of variceal bleeding显示文摘AIM To summarize and critically examine the role of band ligation in secondary prophylaxis of variceal bleeding in patients with cirrhosis. METHODS A literature review was performed using the MEDLINE and PubM ed databases. The search terms consisted of the words 'endoscopic band ligation' OR 'variceal band ligation' OR 'ligation' AND 'secondary prophylaxis' OR 'secondary prevention' AND 'variceal bleeding' OR 'variceal hemorrhage' AND 'liver cirrhosis'. The data collected from relevant meta-analyses and from the most recent randomized studies that were not included in these meta-analyses were used to evaluate the role of endoscopic band ligation in an effort to demonstrate the most recent advances in the treatment of esophageal varices. RESULTS This study included 11 meta-analyses published from 2002 to 2017 and 10 randomized trials published from 2010 to 2017 that evaluated the efficacy of band ligation in the secondary prophylaxis of variceal bleeding. Overall, the results proved that band ligation was superior to endoscopic sclerotherapy. Moreover, the use of β-blockers in combination with band ligation increased the treatment effectiveness, supporting the current recommendations for secondary prophylaxis of variceal bleeding. The use of transjugular intrahepatic portosystemic shunt was superior to combination therapy regarding rebleeding prophylaxis, with no difference in the survival rates; however, the results concerning the hepatic encephalopathy incidence were conflicting. Recent advances in the management of secondary prophylaxis of variceal bleeding have targeted a decrease in portal pressure based on the pathophysiological mechanisms of portal hypertension.CONCLUSION This review suggests that future research should be conducted to enhance current interventions and/or to develop innovative treatment options with improved clinical endpoints. | Ioanna Aggeletopoulou Christos Konstantakis Spilios Manolakopoulos Christos Triantos | 2018 | World Journal of Gastroenterology2018，24，26： | 9 |
| 5 | Adipokines levels are associated with the severity of liver disease in patients with alcoholic cirrhosis显示文摘AIM:To investigate the adipokine levels of leptin,adiponectin,resistin,visfatin,retinol-binding protein 4(RBP4),apelin in alcoholic liver cirrhosis(ALC).METHODS:Forty non-diabetic ALC patients[median age:59 years,males:35(87.5%),Child-Pugh(CP)score:median 7(5-12),CP A/B/C:18/10/12,Model for End-stage Liver Disease(MELD):median 10(6-25),follow-up:median 32.5 mo(10-43)]were prospectively included.The serum adipokine levels were estimated in duplicate by ELISA.Somatometric characteristics were assessed with tetrapolar bioelectrical impedance analysis.Pearson’s rank correlation coefficient was used to assess possible associations with adipokine levels.Univariate and multivariate Cox regression analysis was used to determine independent predictors for overallsurvival.RESULTS:Body mass index:median 25.9(range:20.1-39.3),fat:23.4%(7.6-42.1),fat mass:17.8(5.49-45.4),free fat mass:56.1(39.6-74.4),total body water(TBW):40.6(29.8-58.8).Leptin and visfatin levels were positively associated with fat mass(P<0.001/P=0.027,respectively)and RBP4 with TBW(P=0.025).Median adiponectin levels were significantly higher in CPC compared to CPA(CPA:7.99±14.07,CPB:7.66±3.48,CPC:25.73±26.8,P=0.04),whereas median RBP4 and apelin levels decreased across the spectrum of disease severity(P=0.006/P=0.034,respectively).Following adjustment for fat mass,visfatin and adiponectin levels were significantly increased from CPA to CPC(both P<0.001),whereas an inverse correlation was observed for both RBP4 and apelin(both P<0.001).In the multivariate Cox regression analysis,only MELD had an independent association with overall survival(HR=1.53,95%CI:1.05-2.32;P=0.029).CONCLUSION:Adipokines are associated with deteriorating liver function in a complex manner in patients with alcoholic liver cirrhosis. | Maria Kalafateli Christos Triantos Emmanuel Tsochatzis Marina Michalaki Efstratios Koutroumpakis Konstantinos Thomopoulos Venetsanea Kyriazopoulou Eleni Jelastopulu Andrew Burroughs Chryssoula Lambropoulou-Karatza Vasiliki Nikolopoulou | 2015 | World Journal of Gastroenterology2015，21，10： | 8 |
| 6 | Primary prevention of bleeding from esophageal varices in patients with liver cirrhosis显示文摘Variceal bleeding is a life threatening situation with mortality rates of at least 20%. Prophylactic treatment with non-selective beta blockers(NSBBs) is recommended for patients with small varices that have not bled but with increased risk for bleeding. The recommended treatment strategies on primary prevention of variceal bleeding in patients with medium and largesized varices are NSBBs or endoscopic band ligation. Nitrates, shunt surgery and sclerotherapy are not recommended in this setting. In this review, the most recent data on prevention of esophageal variceal bleeding are presented. Available data derived from randomized-controlled trials suggest both treatment strategies, and according to Baveno V consensus in portal hypertension 'the choice of treatment should be based on local resources and expertise, patient preference and characteristics, side-effects and contra-indications'. | Christos Triantos Maria Kalafateli | 2014 | World Journal of Hepatology2014，6，6： | 6 |
| 7 | Risk of hepatitis B reactivation in patients treated with direct-acting antivirals for hepatitis C显示文摘The recent introduction of direct-acting antiviral drugs(DAAs) for treatment of the hepatitis C virus(HCV) has greatly improved the management of HCV for infected patients. These viral protein inhibitors act rapidly, allowing HCV clearance and increasing the sustained virological response rates. However, hepatitis B virus(HBV) reactivation has been reported in HCV/HBV co-infected patients. Hepatitis B reactivation refers to an abrupt increase in the HBV and is welldocumented in patients with previously undetected HBV DNA due to inactive or resolved HBV infection. Reactivation can occur spontaneously, but in most cases, it is triggered by various factors. Reactivation can be transient, without clinical symptoms; however, it usually causes a hepatitis flare. HBV reactivation may occur regardless of HCV genotype and type of DAA regimen. HBV screening is strongly recommended for co-infected HCV/HBV patients before initiation and during DAA therapy regardless of HBV status, HCV genotype and class of DAAs used. HBV reactivation can be prevented with pretreatment screening and prophylactic treatment when necessary. Additional data are required to evaluate the underlying mechanisms of HBV reactivation in this setting. | Ioanna Aggeletopoulou Christos Konstantakis Spilios Manolakopoulos Christos Triantos | 2017 | World Journal of Gastroenterology2017，23，24： | 5 |
| 8 | Toward a new era of hepatitis B virus therapeutics:The pursuit of a functional cure显示文摘Hepatitis B virus(HBV)infection,although preventable by vaccination,remains a global health problem and a major cause of chronic liver disease.Although current treatment strategies suppress viral replication very efficiently,the optimal endpoint of hepatitis B surface antigen(HBsAg)clearance is rarely achieved.Moreover,the thorny problems of persistent chromatin-like covalently closed circular DNA and the presence of integrated HBV DNA in the host genome are ignored.Therefore,the scientific community has focused on developing innovative therapeutic approaches to achieve a functional cure of HBV,defined as undetectable HBV DNA and HBsAg loss over a limited treatment period.A deeper understanding of the HBV life cycle has led to the introduction of novel direct-acting antivirals that exert their function through multiple mechanisms,including inhibition of viral entry,transcriptional silencing,epigenetic manipulation,interference with capsid assembly,and disruption of HBsAg release.In parallel,another category of new drugs aims to restore dysregulated immune function in chronic hepatitis B accompanied by lethargic cellular and humoral responses.Stimulation of innate immunity by pattern-recognition receptor agonists leads to upregulation of antiviral cytokine expression and appears to contribute to HBV containment.Immune checkpoint inhibitors and adoptive transfer of genetically engineered T cells are breakthrough technologies currently being explored that may elicit potent HBV-specific T-cell responses.In addition,several clinical trials are attempting to clarify the role of therapeutic vaccination in this setting.Ultimately,it is increasingly recognized that elimination of HBV requires a treatment regimen based on a combination of multiple drugs.This review describes the rationale for progressive therapeutic interventions and discusses the latest findings in the field of HBV therapeutics. | Efthymios P Tsounis Evanthia Tourkochristou Athanasia Mouzaki Christos Triantos | 2021 | World Journal of Gastroenterology2021，27，21： | 5 |
| 9 | Impact of muscle wasting on survival in patients with liver cirrhosis显示文摘Muscle wasting is defined as the progressive and generalized loss of muscle mass. Muscle depletion is a common feature of chronic liver disease foundin approximately 40% of patients with cirrhosis. Its etiology is multifactorial subsequent to liver failure and its prevalence increases along with disease severity. Cross-sectional analytic morphometry using computed tomography(CT) scan or magnetic resonance imaging are considered by consensus the gold standards to assess muscle size in cirrhosis for research purposes because they are not biased by fluid accumulation. Several studies have assessed the impact of muscle wasting on overall survival of patients in the waiting list for liver transplantation and there is a general agreement that decreased muscle size assessed by CT scan is an independent predictor for mortality in cirrhosis. It has been proposed that the addition of cross-sectional muscle area into the Model for End-stage Liver Disease can increase its prognostic performance. Nevertheless, the use of CT scan in assessing muscle size is inappropriate for routine clinical practice and an alternative cost-effective, easy to use and accurate tool should be developed. In conclusion, muscle wasting has a detrimental impact on survival of patients with cirrhosis and, thus, it remains to be elucidated if nutritional interventions and exercise could improve muscle wasting and, subsequently, survival in this setting. | Maria Kalafateli Christos Konstantakis Konstantinos Thomopoulos Christos Triantos | 2015 | World Journal of Gastroenterology2015，21，24： | 4 |
| 10 | Intestinal barrier dysfunction in cirrhosis: Current concepts in pathophysiology and clinical implications显示文摘The intestinal lumen is a host place for a wide range of microbiota and sets a unique interplay between local immune system, inflammatory cells and intestinal epithelium, forming a physical barrier against microbial invaders and toxins. Bacterial translocation is the migration of viable or nonviable microorganisms or their pathogen-associated molecular patterns, such as lipopolysaccharide, from the gut lumen to the mesenteric lymph nodes, systemic circulation and other normally sterile extraintestinal sites. A series of studies have shown that translocation of bacteria and their products across the intestinal barrier is a commonplace in patients with liver disease. The deterioration of intestinal barrier integrity and the consulting increased intestinal permeability in cirrhotic patients play a pivotal pathophysiological role in the development of severe complications as high rate of infections, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding, progression of liver injury and hepatocellular carcinoma. Nevertheless, the exact cellular and molecular mechanisms implicated in the phenomenon of microbial translocation in liver cirrhosis have not been fully elucidated yet. | Georgios I Tsiaoussis Stelios F Assimakopoulos Athanassios C Tsamandas Christos K Triantos Konstantinos C Thomopoulos | 2015 | World Journal of Hepatology2015，7，17： | 4 |
| 11 | 化疗栓塞联合其他方法治疗肝细胞癌的评价显示文摘 引言
肝癌是世界上第5 种最常见的肿瘤且其发病率仍在上升.在欧洲,80%的肝细胞癌(HCC)并发于肝硬化且是其主要死因.
虽然公布了一些方案,但对HCC 病人的常规治疗策略并没有取得世界范围内的统一.巴塞罗那临床肝癌(BCLC)分类和治疗方案于最近公布.按照该方案,放疗[包括切除、肝移植、经皮消融(经皮乙醇注射以及射频)]可以运用于30%~40%的HCC 病人,而另外更多的病人则需要采用其他的手段.…… | Marelli L Stigliano R Triantos C 刘军麟 | 2007 | 中华普通外科学文献(电子版)2007，1，3： | 3 |
| 12 | Nucleic acid vaccines: A taboo broken and prospect for a hepatitis B virus cure显示文摘Although a prophylactic vaccine is available,hepatitis B virus(HBV)remains a major cause of liver-related morbidity and mortality.Current treatment options are improving clinical outcomes in chronic hepatitis B;however,true functional cure is currently the exception rather than the rule.Nucleic acid vaccines are among the emerging immunotherapies that aim to restore weakened immune function in chronically infected hosts.DNA vaccines in particular have shown promising results in vivo by reducing viral replication,breaking immune tolerance in a sustained manner,or even decimating the intranuclear covalently closed circular DNA reservoir,the hallmark of HBV treatment.Although DNA vaccines encoding surface antigens administered by conventional injection elicit HBVspecific T cell responses in humans,initial clinical trials failed to demonstrate additional therapeutic benefit when administered with nucleos(t)ide analogs.In an attempt to improve vaccine immunogenicity,several techniques have been used,including codon/promoter optimization,coadministration of cytokine adjuvants,plasmids engineered to express multiple HBV epitopes,or combinations with other immunomodulators.DNA vaccine delivery by electroporation is among the most efficient strategies to enhance the production of plasmid-derived antigens to stimulate a potent cellular and humoral anti-HBV response.Preliminary results suggest that DNA vaccination via electroporation efficiently invigorates both arms of adaptive immunity and suppresses serum HBV DNA.In contrast,the study of mRNA-based vaccines is limited to a few in vitro experiments in this area.Further studies are needed to clarify the prospects of nucleic acid vaccines for HBV cure. | Efthymios P Tsounis Athanasia Mouzaki Christos Triantos | 2021 | World Journal of Gastroenterology2021，27，41： | 3 |
| 13 | Changes in the esophageal mucosa of patients with non erosive reflux disease:How far have we gone?显示文摘The normal esophageal mucosa creates a protective epithelial barrier that constrains the acidic reflux in the esophageal lumen. Microscopic findings and functional studies indicate that this barrier might be impaired in patients with non erosive reflux disease(NERD) but not in patients with functional heartburn(FH). Whereas endoscopy and pH monitoring are the most important diagnostic tools in the diagnosis of NERD, recent studies suggest that esophageal biopsies might have a complementary role. Particularly in the differential diagnosis between NERD and FH, the application of histological severity scores showed very promising results. Further evaluation of the scores could lead to routine application of histology in specific NERD populations. | Christos Triantos Nikolaos Koukias Georgios Karamanolis Konstantinos Thomopoulos | 2015 | World Journal of Gastroenterology2015，21，19： | 3 |
| 14 | A rare etiology of post-endoscopic retrograde cholangiopancreatography pneumoperitoneum显示文摘Major complications of endoscopic retrograde cholangiopancreatography (ERCP) include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. The occurrence of free air in the peritoneal cavity post- ERCP is a rare event (< 1%), which is usually the result of duodenal or ductal perforation related to therapeutic ERCP with sphincterotomy. We describe for the first time a different aetiology of pneumoperitoneum, in an 84-year-old woman with pancreatic cancer and a large hepatic metastasis, after ERCP with common bile duct stent deployment. Our patient developed, pneumoperitoneum due to air leakage from rupture of intrahepatic bile ducts and Glisson’s capsule in the area of a peripheral large hepatic metastasis. The potential mechanism underlying this complication might be post- ERCP pneumobilia and increased pressure of intrahepatic bile ducts leading to rupture of intrahepatic bile ducts in the liver metastatic mass owing to neoplastic tissue friability. This case indicates the need for close clinical and radiological observation of patients with hepatic masses (primary or metastatic) subjected to ERCP. In such patients, avoidance of excessive air insufflation during ERCP and/or placement of a nasogastric tube for bowel decompression immediately after ERCP might be a reasonable strategy to prevent such unusual complications. | Stelios F Assimakopoulos Konstantinos C Thomopoulos Sofia Giali Christos Triantos Dimitrios Siagris Charalambos Gogos | 2008 | World Journal of Gastroenterology2008，14，18： | 2 |
| 15 | Interleukin 12/interleukin 23 pathway: Biological basis and therapeutic effect in patients with Crohn's disease显示文摘Considering that both innate and adaptive immune responses are involved in the pathogenesis of Crohn's disease(CD), novel therapeutic options have significantly been developed. Biological agents represent an important addition to the conventional treatments for immuno-inflammatory conditions, acting as antagonists of adhesion molecules or various inflammatory cytokines. The interleukin 12(IL-12)/IL-23 common pathway has been found to play a determinant role in the induction of inflammation in adaptive immune responses. In particular, IL-23 promotes the differentiation of na?ve T helper cells into Th17 phenotype with the concomitant secretion of several inflammatory cytokines such as IL-17 and IL-22, whereas IL-12 induces the Th1 polarization and production of critical cytokines such as interferon-γ and tumor necrosis factor. Nowadays, there is increased interest regarding the role of IL-23 as a therapeutic target of CD through the blockage of IL-23 mediated pathways. In this editorial, we focus on the role of IL-12/IL-23 pathway in the regulation of mucosal immunity and in the induction and maintenance of chronic inflammation. In parallel, we critically discuss the available data regarding the therapeutic effect of the IL-12/IL-23 inhibitors and especially of ustekinumab, a human monoclonal antibody which has been recently approved by the United States Food and Drug Administration for the management of moderateto-severe CD and its potential to be used as first-line therapy in everyday clinical practice. | Ioanna Aggeletopoulou Stelios F Assimakopoulos Christos Konstantakis Christos Triantos | 2018 | World Journal of Gastroenterology2018，24，36： | 2 |
| 16 | Transarterial Therapy for Hepatocellular Carcinoma: Which Technique Is More Effective? A Systematic Review of Cohort and Randomized Studies显示文摘 | Laura Marelli Rosa Stigliano Christos Triantos Marco Senzolo Evangelos Cholongitas Neil Davies Jonathan Tibballs Tim Meyer David W. Patch Andrew K. Burroughs | 2007 | CardioVascular and Interventional Radiology2007，，1： | 2 |
| 17 | Infection,coagulation,and variceal bleeding in cirrhosis显示文摘 | Thalh eimer U Triantos CK Samonakis DN | 2005 | Gut2005，54，4： | 1 |
| 18 | Gastrointestinal bleeding:Carvedilol-the best beta-blocker for primary prophylaxis显示文摘 | Tsochatzis EA Triantos CK Burroughs AK | 2009 | Nat Rev Gastroenterol Hepatol2009，6，12： | 1 |
| 19 | Method for Improving the Performance of por- ous Membrane Reactor显示文摘 | Trianto A Kokugan T | 2001 | Chem Eng Japan2001，34，4： | 1 |
| 20 | Management of varices inpatients with cirrhosis 显示文摘 | QBrien J Triantos C Burroughs AK | 2013 | Nat Rev Gastroenterol Hepatol2013，10，7： | 1 |
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