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001-es BibID:BIBFORM132333
035-os BibID:(Scopus)105015632626
Első szerző:Balogh Boglárka (belgyógyász)
Cím:Secretory IgA Is a Key Marker Among Gut Barrier Dysfunction-Related Immunoglobulins Predicting Outcomes in ACLF / Balogh Boglarka, Tornai David, Csillag Aniko, Tornai Istvan, Vitalis Zsuzsana, Kovats Patricia, Antal-Szalmas Peter, Dinya Tamas, Laleman Wim, Coenraad Minneke J., Trebicka Jonel, Papp Maria, MICROB-PREDICT
Dátum:2025
ISSN:1478-3223
Megjegyzések:ABSTRACT Background and Aims: In cirrhosis, impaired gut mucosal immunity facilitates bacterial translocation (BT) instigating the proinflammatory cascade that exacerbates hepatic damage. The role of antibody-mediated immunity in this process remains unclear. We assessed serum immunoglobulins (Ig) linked to gut barrier function as prognostic markers in a prospective MICROBPREDICT cohort of patients with acutely decompensated (AD) cirrhosis. Methods: Serum samples of 128 patients were assayed for IgA and IgG antibodies against various targets (filamentous-actin; Saccharomyces cerevisiae [ASCA]; glycoprotein-2 [GP2]; gliadin; endotoxin-core [EndoCab]), secretory (s)IgA, total-IgA, IgG, IgM and free Ig kappa/lambda light chains. Mortality was assessed during a 3-month follow-up period. An independent ACLF patient cohort (n=50) was used to validate sIgA-related findings. Results: IgA-type target-specific antibodies were more prevalent than IgG types. Target-specific antibody diversity and concentrations, total-IgA levels and Child?Pugh severity exhibited concordant elevations. Total-IgG levels were inversely associated with CLIF-C AD score and presence of ACLF. sIgA levels increased in parallel with ACLF grades. Elevated sIgA levels were associated with 90-day mortality in ACLF patients (n=37; AUROC: 0.859; at the cut-off of >20.9?g/mL: 11.1% vs. 78.9% Mortality p<0.001). These findings were confirmed in the validation cohort. In the merged ACLF cohort (n=87), high sIgA levels predicted 90-day mortality independent of CLIF-C ACLF score (HR: 3.367; CI: 1.563?7.225; p=0.002). Conclusion: Enhanced BT-triggered immune activation is indicated by increased total-IgA levels in association with the occurrence of target-specific IgA antibodies. Serum sIgA is a promising marker of gut barrier failure and 90-day mortality in ACLF.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
acute-on-chronic liver failure
adaptive immunity
gut barrier failure
immunoglobulin A
secretory IgA
short-term mortality
Megjelenés:Liver International. - 45 : 10 (2025), p. 1-12. -
További szerzők:Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Csillag Anikó (1979-) (immunológus, biológus, angol-magyar szakfordító) Tornai István (1954-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Kováts Patrícia (1995-) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Laleman, Wim Coenraad, Minneke Trebica, Jonel Papp Mária (1975-) (belgyógyász, gasztroenterológus) MICROB-PREDICT Consortium
Pályázati támogatás:H2020 138041
Egyéb
ÚNKP-23-5
Egyéb
Bólyai 825694
MTA
Internet cím:Szerző által megadott URL
DOI
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2.

001-es BibID:BIBFORM133955
035-os BibID:(scopus)105024188361 (wos)001630712600001
Első szerző:Tornai Dávid (hepatológia, biomarker kutatás)
Cím:Serum Villin-1 - A novel marker of gut barrier damage in acutely decompensated cirrhosis : a cohort study and validation / David Tornai, Boglarka Balogh, Aniko Csillag, Andras Budai, Andras Kiss, Peter Antal-Szalmas, Gabor Mehes, Lukacs Barath, Tamas Tornai, Istvan Tornai, Zsuzsanna Vitalis, Nora Sipeki, Tamas Dinya, Attila Enyedi, Florian A. Rosenberger, Wim Laleman, Minneke J. Coenraad, Ferran Aguilar, Joan Claria, Richard Moreau, Jonel Trebicka, Maria Papp, ICROB-PREDICT & PREDICT study group of the EASL-CLIF consortium
Dátum:2026
ISSN:0269-2813 1365-2036
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Alimentary Pharmacology & Therapeutics. - 63 : 7 (2026), p. 1018-1032. -
További szerzők:Balogh Boglárka (1993-) (belgyógyász) Csillag Anikó (1979-) (immunológus, biológus, angol-magyar szakfordító) Budai András Kiss András Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Méhes Gábor (1966-) (patológus) Baráth Lukács Tornai Tamás István (1984-) (belgyógyász) Tornai István (1954-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Sipeki Nóra (1987-) (általános orvos) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Enyedi Attila (1975-) (sebész) Rosenberger, Florian A. Laleman, Wim Coenraad, Minneke Aguilar, Ferran Claria, Joan Moreau, Richard Trebica, Jonel Papp Mária (1975-) (belgyógyász, gasztroenterológus) ICROB-PREDICT & PREDICT study group of the EASL-CLIF consortium
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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3.

001-es BibID:BIBFORM117716
035-os BibID:(WoS)001177385500001 (Scopus)85185348688
Első szerző:Torp, Nikolaj
Cím:Personalised human albumin in patients with cirrhosis and ascites : design and rationale for the ALB-TRIAL - a randomised clinical biomarker validation trial / Nikolaj Torp, Mads Israelsen, Minneke Coenraad, Maria Papp, Debbie L. Shawcross, Marko Korenjak, Paolo Angeli, Wim Laleman, Adria Juanola, Pere Gines, Jonel Trebicka, Alexander Krag, MICROB-PREDICT Consortium
Dátum:2024
ISSN:2044-6055
Megjegyzések:Abstract Introduction; Human albumin is used in the treatment of complications of cirrhosis. However, the use of long-term human albumin administration is costly and resource demanding for both patients and healthcare systems. A precision medicine approach with biomarkers to predict human albumin treatment response, so called predictive biomarkers, could make this a viable treatment option in patients with cirrhosis and ascites. Methods and analysis; ALB-TRIAL is a multinational, double-blind, placebo-controlled randomised controlled rial. We aim to validate a predictive biomarker, consisting of a panel of circulating metabolites, to predict the treatment response to human albumin in patients with cirrhosis and ascites. All enrolled patients are stratified into a high- or low expected effect stratum of human albumin based on the biomarker outcome. After stratification, patients in each group are randomised into either active treatment (20% human albumin) or corresponding placebo (0.9% NaCl) every 10th day for 6 months. The primary outcome is the cumulative number of liver-related events (composite of decompensation episodes, transjugular intrahepatic shunt insertion, liver transplantation and death). Key secondary outcomes include time-to-event analysis of primary outcome components, an analysis of the total healthcare burden and a health economic analysis. Ethics and dissemination; The trial obtained ethical- and regulatory approval in Denmark, Germany, the Netherlands, Belgium, Hungary and Spain through the Clinical Trials Information System (CTIS) from 13 February 2023, while United Kingdom approvals from the Health Regulatory Authority (HRA), Medicines and Healthcare products Regulatory Agency (MHRA) and Research Ethics Committee (REC) are pending. Findings will be published in peer-reviewed journals, presented at conferences, communicated to relevant stakeholders and in the public registry of CTIS, following trial completion.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
cirrhosis
biomarker
RCT
validation
ascites
albumin
personalised medicine protocol
Megjelenés:BMJ Open. - 14 : 2 (2024), p. 1-8. -
További szerzők:Israelsen, Mads Coenraad, Minneke Papp Mária (1975-) (belgyógyász, gasztroenterológus) Shawcross, Debbie L. Korenjak, Marko Angeli, Paolo Laleman, Wim Juanola, Adria Ginès, Pere Trebica, Jonel Krag, Aleksander Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Balogh Boglárka (1993-) (belgyógyász) MICROB-PREDICT Consortium
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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4.

001-es BibID:BIBFORM088130
035-os BibID:(WoS)000640696100013 (Scopus)85101877901
Első szerző:Trebica, Jonel
Cím:PREDICT identifies Precipitating Events Associated with Clinical Course of Acutely Decompensated Cirrhosis / Jonel Trebicka, Javier Fernandez, Maria Papp, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Ushcner, Christian Jansen, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Peter Jarcuska, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, Debbie Shawcross, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Karen V. Danielsen, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Jose Presa Ramos, Cristina Sole, German Soriano, Andrea de Gottardi, Henning Groenbaek Faouzi, Saliba Trautwein, Christian Haluk, Tarik Kani, Sven Francque, Stephen Ryder, Pierre Nahon, Manuel Romero Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Michael Praktiknjo, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, William Bernal, Ferran Aquilar, Joan Claria, Paolo Ponzo, Zsuzsanna Vitalis, Giacomo Zaccherini, Boglarka Balogh, Alexander Gerbes, Victor Vargas, Carlo Alessandria, Mauro Bernardi, Pere Gines, Richard Moreau, Paolo Angeli, Rajiv Jalan, Vicente Arroyo
Dátum:2021
ISSN:0168-8278
Megjegyzések:ABSTRACT Introduction: Acute decompensation (AD) of cirrhosis may present without acute-onchronic liver failure (ACLF) (AD-No ACLF), or with ACLF-phenotype (AD-ACLF) defined by organ failure(s). Precipitating events may induce AD. This multicenter,prospective, observational PREDICT Study (NCT03056612) analyzes and characterizes the precipitants leading to both AD-phenotypes. Patients and Methods: The PREDICT study included 1273 non-electively hospitalized patients with AD (No-ACLF=1071; ACLF=202). Medical history, clinical and laboratory data were carefully collected at enrolment and during 90-days follow up, focused on the characteristics of precipitants, specifically induction of organ dysfunction/failure and/or systemic inflammation, chronology, intensity, and relationship to outcome in both AD phenotypes. Results: Among different clinical events, four distinct events were precipitants consistently related to AD, including proven bacterial infections, severe alcoholic hepatitis, gastrointestinal (GI) bleeding with shock and toxic encephalopathy. Among patients in the AD-No ACLF cohort and the AD-ACLF cohort with precipitants (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Interestingly, in both AD-phenotypes, proven bacterial infections and severe alcoholic hepatitis had a similar association withsurvival, and the number of precipitants was associated with significantly increased 90-day mortality, in paralleled by surrogates of systemic inflammation confirming a valid definition of precipitating events. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with lower ACLF development rate and higher 90-day survival. Conclusions: This study identified precipitating events that are significantly associated with a distinct clinical course and prognosis of patients with AD and specific preventive and therapeutic strategies targeting these events may improve outcome in decompensated cirrhosis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
chronic liver disease
non-elective admission
acute complications
outcome
risk factors
Megjelenés:Journal of Hepatology. - 74 : 5 (2021), p. 1097-1108. -
További szerzők:Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jansen, Christian Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Jarcuska, Peter Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Shawcross, Debbie Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Danielsen, Karen V. Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Ramos, José Sole, Cristina Soriano, German Gottardi, Andrea De Faouzi, Henning Groenbaek Trautwein, Saliba Haluk, Christian Kani, Tarik Francque, Sven Ryder, Stephen Nahon, Pierre Gomez, Manuel Romero Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Praktiknjo, Michael Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Bernal, William Aquilar, Ferran Claria, Joan Ponzo, Paolo Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Gerbes, Alexander Vargas, Victor Alessandria, Carlo Bernardi, Mauro Ginès, Pere Moreau, Richard Angeli, Paolo Jalan, Rajiv Arroyo, Vicente
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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5.

001-es BibID:BIBFORM086407
035-os BibID:(WoS)000572079900019 (Scopus)85088972261
Első szerző:Trebica, Jonel
Cím:The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology / Jonel Trebicka, Javier Fernandez, Papp Mária, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Uschner, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Martin Janicko, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, William Bernal, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Lise Lotte Gluud, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Ana Cristino, Cristina Sole, Germán Soriano, Andrea de Gottardi, Henning Groenbaek, Faouzi Saliba, Christian Trautwein, Osman Cavit Özdogan, Francque Sven, Stephen Ryder, Pierre Nahon, Manuel Romero-Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, Debbie Showcross, Ferran Aguilar, Joan Claria, Paolo Ponzo, Christian Jansen, Vitális Zsuzsanna, Giacomo Zaccherini, Balogh Boglárka, Victor Vargas, Sara Montagnese, Carlo Alessandria, Mauro Bernardi, Pere Gines, Rajiv Jalan, Richard Moreau, Paolo Angeli, Vicente Arroyo
Dátum:2020
ISSN:0168-8278
Megjegyzések:Background/Aims:Acute decompensation (AD) of cirrhosis is defined by the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, i nfection or any combination of these, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF), while their absence defines AD. We designed the PREDICT study, a European, prospective, observational study, to characterize the clinical course of AD and predict ACLF . Methods:A total of 1071 patients with AD were enrolled to collect detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed-up for 3 months. The 12-month outcomes (liver transplantation, and death) were also recorded. Results:Three groups of patients were identified: Pre-ACLF patients (n=218), who developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ?1 readmission but not developing ACLF and had 21.0% and 35.6% mortality rates. Stable decompensated cirrhosis (SDC) patients (n = 620) who were neither readmitted, nor developed ACLF and showed a 1-year mortality of only 9.5%. The 3 groups differed significantly in the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in the SDC) and prevalence of surrogates of severe portal hypertension throughout the study (high in UDC versus low in pre-ACLF and SDC). Conclusions:Acute decompensation without ACLF is a heterogeneous condition with three different clinical courses and two major pathophysiological mechanisms: systemic inflammation and portal hypertension. Prediction of ACLF development remains a major future task.(ClinicalTrials.gov number, NCT03056612)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Chronic liver disease
non-elective admission
acute complications
Outcome
Risk factors
Megjelenés:Journal of Hepatology. - 73 (2020), p. 842-854. -
További szerzők:Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Janicko, Martin Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Bernal, William Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Gluud, Lise Lotte Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Cristino, Ana Sole, Cristina Soriano, German Gottardi, Andrea De Groenbaek, Henning Saliba, Faouzi Trautwein, Christian Özdogan, Osman Cavit Sven, Francque Ryder, Stephen Nahon, Pierre Romero-Gomez, Manuel Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Showcross, Debbie Aguilar, Ferran Claria, Joan Ponzo, Paolo Jansen, Christian Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Vargas, Victor Montagnese, Sara Alessandria, Carlo Bernardi, Mauro Ginès, Pere Jalan, Rajiv Moreau, Richard Angeli, Paolo Arroyo, Vicente
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