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001-es BibID:BIBFORM071355
Első szerző:Antal-Szalmás Péter (laboratóriumi szakorvos)
Cím:Serum levels of lectin complement pathway molecules do not determine the risk of bacterial infections in patients with cirrhosis / P. Antal-Szalmás, I. Földi, D. Tornai, T. Tornai, Zs. Vitális, I. Tornai, T. Dinya, M. Papp
Dátum:2016
Megjegyzések:SE1.5Serum levels of lectin complement pathway molecules do not determine the risk of bacterial infections in patientswith cirrhosisP. Antal-Szalmás1, I. Földi2, D. Tornai1, T. Tornai2, Zs. Vitális2, I Tornai2, T. Dinya3, M. Papp21Department of Laboratory Medicine, 2Department of Internal Medicine, Division of Gastroenterology, 3Institute of Surgery, Faculty ofMedicine, University of Debrecen, Debrecen, HungaryBacterial infections are a significant cause of morbidity and mortality in cirrhosis. Lectin pathway molecules of the complement system aresynthesized in the liver and have a pivotal role in the innate host defense against infectious organisms. Mannose-binding lectin (MBL) andficolins (FCNs) act as soluble pattern recognition molecules, while mannan-binding lectin serine proteases (MASPs) are effector molecules inelimination of the pathogens. Low levels of the functional proteins increase the risk of various infectious diseases but their significance hasscarcely been investigated in cirrhosis related bacterial infections.Sera of 266 patients with cirrhosis and 160 healthy subjects were assayed for the concentrations of FCN-2, FCN-3 and MASP-2 by ELISAs.In cirrhosis, a 5-year follow-up observational study was conducted to assess a possible association between lectin levels and development ofclinically significant bacterial infections (CSI) and mortality.The FCN-2, FCN-3 and MASP-2 levels were significantly lower in cirrhosis compared to healthy controls (505 vs. 769 ng/ml, 7,301 vs.10,797 ng/ml and 212 vs. 412 ng/ml, respectively, p < 0.001 for all) and decreased according to disease severity as rated by Child-Pughstage. In Kaplan-Meier analysis time to development of CSI was associated with low level of FCN-3 ( < 4,857 ng/ml, p = 0.028) but notFCN-2 ( < 427 ng/ml, p = 0.068) or MASP-2 deficiency (p = 0.368). Combined FCN deficiency even more than individual molecules wereable to predict the development of these episodes. Patients with low level of both FCNs had a cumulative risk of an infection of 52%as compared to 31% with normal level of FCNs (p = 0.021). In multivariate Cox-regression analysis, clinical factors but not the serumlectin profile remained an independent predictor of CSI. Prior episode of CSI and in a stepwise manner, the disease severity as rated byChild-Pugh stage conferred higher risk for development of CSI (HR: 2.64, 95% CI: 1.74?3.99, p < 0.001 and 2.11, 95%CI: 1.52-2.93, p < 0.001,respectively).In the present prospective study, diseases severity and prior episode of CSI but not the serum lectin profile were major determinants ofthe risk of CSI in cirrhosis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
Megjelenés:Clinical chemistry and laboratory medicine 54 : 10 (2016), p. 162. -
További szerzők:Földi Ildikó (1981-) (orvos) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Tornai Tamás István (1984-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
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2.

001-es BibID:BIBFORM071451
Első szerző:Dinya Tamás (sebész szakorvos, onkológus szakorvos)
Cím:Functional polymorphisms of innate immunity receptors are not risk factors for the non-SBP type bacterial infections in cirrhosis / Dinya Tamás, Tornai Tamás, Vitális Zsuzsanna, Tornai István, Balogh Boglárka, Tornai Dávid, Antal-Szalmás Péter, Sümegi Andrea, Andrikovics Hajnalka, Bors András, Tordai Attila, Papp Mária
Dátum:2018
ISSN:1478-3223 1478-3231
Megjegyzések:Background&Aims: Pattern recognition receptors (PRRs) have a key role in the innate host defense. Functional polymorphisms of various PRRs have been established to contribute to an increased susceptibility to spontaneous bacterial peritonitis (SBP). Their role in the development of cirrhosis-associated bacterial infections (BI), beyond SBP or progressive disease course related to pathological bacterial translocation (BT) remains unknown. Methods: 349 patients with cirrhosis were genotyped for common NOD2 (R702W, G908R and L1007PfsinsC), TLR2 (-16934T>A), and TLR4 (D299G) gene variants. Incidence of BIs, decompensating events (ascites, variceal bleeding and hepatic encephalopathy) and liver-related death were assessed in a 5-year follow-up observational study. Pathological BT was assessed based on the presence of anti-microbial antibodies or lipopolysaccharide-binding protein (LBP) level. Results: In patients with ascites (n=88) only NOD2 gene variants were associated with an increased cumulative probability of SBP compared to wild-type (76.9%?19.9% vs. 30.9%?6.9%, PLogRank=0.047). Neither individual polymorphisms, nor combined PRR genetic profiles were associated with the risk of non-SBP type BI. Advanced disease stage (HR,[95%CI]: 2.11 [1.38-3.25]) and prior history of a BI episode (HR: 2.42 [1.58-3.72]) were the major clinical risk factors of a subsequent BI. The risk of a non-SBP type BI in patients with advanced disease and a prior BI was even higher (HR: 4.74 [2.68-8.39]). The frequency of anti-microbial antibodies and LBP levels did not differ between various PRR genotypes. Correspondingly, PRR genetic profile was not able to predict the long-term disease course. Conclusions: In cirrhosis, functional polymorphisms of PRRs did not improve the identification of patients with high risk of BI beyond SBP or progressive diseases course.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
pattern recognition receptors
genetic polymorphisms
cirrhosis
bacterial infection
complication
mortality
Megjelenés:Liver International. - 38 : 7 (2018), p. 1242-1252. -
További szerzők:Tornai Tamás István (1984-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Balogh Boglárka (1993-) (belgyógyász) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Sümegi Andrea (1969-) (biológus) Andrikovics Hajnalka Bors András Tordai Attila Papp Mária (1975-) (belgyógyász, gasztroenterológus)
Pályázati támogatás:OTKA-115818
OTKA
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3.

001-es BibID:BIBFORM066819
Első szerző:Földi Ildikó (orvos)
Cím:Lectin-complement pathway molecules are decreased in patients with cirrhosis and constitute the risk of bacterial infections / Ildiko Foldi, Tamas Tornai, David Tornai, Nora Sipeki, Zsuzsanna Vitalis, Istvan Tornai, Tamas Dinya, Peter Antal-Szalmas, Maria Papp
Dátum:2017
ISSN:1478-3223
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Liver International 37 : 7 (2017), p. 1023-1031. -
További szerzők:Tornai Tamás István (1984-) (belgyógyász) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Sipeki Nóra (1987-) (általános orvos) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
Pályázati támogatás:K115818/2015/1
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4.

001-es BibID:BIBFORM065752
Első szerző:Papp Mária (belgyógyász, gasztroenterológus)
Cím:Presepsin teardown : pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis / Maria Papp, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Tamas Dinya, Andrea Sumegi, Peter Antal-Szalmas
Dátum:2016
Megjegyzések:AIM: Bacterial infections are frequent complications in cirrhosis with significant mortality. Early laboratory diagnosis is essential but challenging. We aimed to evaluate the diagnostic and prognostic value of presepsin in cirrhosis associated bacterial infections. METHODS: 216 patients with cirrhosis were enrolled. At admission, presence of bacterial infections and level of plasma presepsin, serum CRP and PCT were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality. RESULTS: 34.7% of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 vs. 477 pg/mL, p<0.001), increasing with the severity of infection (organ failure[OF]Yes vs. No: 2358 vs. 710 pg/mL, p<0.001). Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, p=NS for presepsin vs. PCT and p<0.01 for presepsin vs. CRP). At the optimal cut-off value of presepsin>1206 pg/mL sensitivity, specificity, PPV and NPV were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-day mortality rate was higher among patients with >1277 pg/mL compared to those with ?1277 pg/mL (46.9% vs. 11.6%, p<0.001). In a binary logistic regression analysis, however, only PCT [OR: 1.81, (95%CI: 1.09?3.01), p=0.022] but neither presepsin and nor CRP were independent risk factor for 28-day mortality after adjusting with MELD score and leukocyte count.CONCLUSION: Presepsin is a valuable new biomarker for defining severe infections in cirrhosis proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
presepsin
cirrhosis
bacterial infection
organ failure
mortality
Megjelenés:World Journal of Gastroenterology 22 : 41 (2016), p. 1-14. -
További szerzők:Tornai Tamás István (1984-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Sümegi Andrea (1969-) (biológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
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5.

001-es BibID:BIBFORM102210
Első szerző:Tornai Tamás István (belgyógyász)
Cím:Soluble CD163 (SCD163) is a marker of infection in patients with cirrhosis and acute decompensation and an independent predictor of the short-term mortality / Tornai Tamás, Tornai Dávid, Sipeki Nóra, Földi Ildikó, Dinya Tamás, Vitalis Zsuzsanna, Antal-Szalmás Péter, Tornai István, Papp Mária
Dátum:2015
ISSN:0168-8278
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:Journal Of Hepatology. - 62 : Supplement 2 (2015), p. S368. -
További szerzők:Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Sipeki Nóra (1987-) (általános orvos) Földi Ildikó (1981-) (orvos) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Tornai István (1954-) (belgyógyász, gasztroenterológus) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
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6.

001-es BibID:BIBFORM063221
Első szerző:Tornai Tamás István (belgyógyász)
Cím:Macrophage activation marker, soluble CD163 is an independent predictor of short-term mortality in patients with cirrhosis and bacterial infection / Tornai Tamas, Vitalis Zsuzsanna, Sipeki Nora, Dinya Tamas, Tornai David, Antal-Szalmas Peter, Karanyi Zsolt, Tornai Istvan, Papp Maria
Dátum:2016
ISSN:1478-3223
Megjegyzések:BACKGROUND&AIMS: Innate immune system dysfunction is common in advanced cirrhosis, with a central role of the monocyte/macrophage system. Monocytes and macrophages express the scavenger receptor CD163 which is regulated by inflammatory mediators. Cleavage of the receptor leads to formation of soluble (s)CD163, that represents anti-inflammatory response. We aimed to study the clinical importance of sCD163 in cirrhosis.METHODS:Sera of 378 patients were assayed for sCD163 by ELISA (193 outpatients and 185 patients with acute decompensation[AD]). A 5-year follow-up observational study was conducted to assess the possible association between sCD163 level and poor disease outcomes.RESULTS: sCD163 level was associated with disease severity, but not with the presence of varices or prior variceal bleeding. In outpatients, sCD163 level did not predict the development of disease-specific complications or the long-term mortality. In patients with AD episode, sCD163 level was significantly higher compared to outpatients but only in the presence of bacterial infection[INF] (AD-INF:4586, AD-NON-INF:3792 and outpatients: 3538ng/mL, p<0.015 and p=0.001, respectively). sCD163 level gradually increased according to severity of infection. During bacterial infections, high sCD163 level(>7000ng/mL) was associated with increased mortality rate (42% vs. 17%, p<0.001) and was identified as an independent predictor of 28-day mortality (HR:2.96, 95%CI:1.27-6.95) in multivariate Cox-regression model comprising etiology, co-morbidity, MELD score and leukocyte count as covariates.CONCLUSIONS:High sCD163 level is useful to identify patients with high-risk of death during an AD episode complicated by bacterial infection. This finding serves as an additional hint towards the significance of anti-inflammatory response during bacterial infection. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
sCD163
cirrhosis
anti-inflammatory response
Megjelenés:Liver International 36 : 11 (2016), p. 1628-1638. -
További szerzők:Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Sipeki Nóra (1987-) (általános orvos) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Karányi Zsolt (1961-) (biostatisztikus, bioinformatikus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
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