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001-es BibID:	BIBFORM013687
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Presence of Anti-Microbial Antibodies in Liver Cirrhosis : a Tell-Tale Sign of Compromised Immunity? / Papp Maria, Norman Gary L., Vitalis Zsuzsanna, Tornai Istvan, Altorjay Istvan, Földi Ildikó, Udvardy Miklos, Shums Zakera, Dinya Tamas, Orosz Peter, Lombay Bela, Par Gabriella, Par Alajos, Veres Gabor, Csak Timea, Osztovits Janos, Szalay Ferenc, Lakatos Peter Laszlo
Dátum:	2010
ISSN:	0163-2116
Megjegyzések:	Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections. Methodology/Principal Findings: Sera of 676 patients with various chronic liver diseases (autoimmune diseases:266, viral hepatitis C:124, and liver cirrhosis of different etiology:286) and 100 controls were assayed for antibodies to Saccharomyces cerevisiae(ASCA) and to antigens derived from two intestinal bacterial isolates (one gram positive, one gram negative, neither is Escherichia coli). In patients with liver cirrhosis, we also prospectively recorded the development of severe episodes of bacterial infection. ASCA and anti-OMP PlusTM antibodies were present in 38.5% and 62.6% of patients with cirrhosis and in 16% and 20% of controls, respectively (p,0.001). Occurrence of these antibodies was more frequent in cases of advanced cirrhosis (according to Child-Pugh and MELD score; p,0.001) or in the presence of ascites (p,0.001). During the median follow-up of 425 days, 81 patients (28.3%) presented with severe bacterial infections. Anti-microbial antibody titers (p = 0.003), as well as multiple seroreactivity (p = 0.036), was associated with infectious events. In logistic regression analysis, the presence of ascites (OR:1.62, 95%CI:1.16?2.25), co-morbidities (OR:2.22, 95%CI:1.27?3.86), and ASCA positivity (OR:1.59, 95%CI:1.07?2.36) were independent risk factors for severe infections. A shorter time period until the first infection was associated with the presence of ASCA (p = 0.03) and multiple seropositivity (p = 0.037) by Kaplan-Meier analysis, and with Child-Pugh stage (p = 0.018, OR:1.85) and co-morbidities (p,0.001, OR:2.02) by Cox-regression analysis. Conclusions/Significance: The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Haptoglobin polymorphism Crohn's disease Disease behavior Th1/Th2 orientation Primary sclerosing cholangitis egyetemen (Magyarországon) készült közlemény
Megjelenés:	PloS One. - 5 : 9 (2010), p. e12957-1-e12957-9. -
További szerzők:	Norman, Gary L. Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Földi Ildikó (1981-) (orvos) Udvardy Miklós (1947-) (belgyógyász, haematológus) Shums, Zakera Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Orosz Péter (Miskolc) Lombay Béla Jr. Pár Gabriella Pár Alajos Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Csak Timea Osztovits János Szalay Ferenc (belgyógyász) Lakatos Péter (Semmelweis Egyetem)
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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