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001-es BibID:	BIBFORM078868
035-os BibID:	(PMID)31464790
Első szerző:	Janka Tamás
Cím:	Deleterious effect of proton pump inhibitors on the disease course of cirrhosis / Tamas Janka, Tamas Tornai, Brigitta Borbely, David Tornai, Istvan Altorjay, Maria Papp, Zsuzsanna Vitalis
Dátum:	2020
Megjegyzések:	OBJECTIVES: Proton pump inhibitors (PPIs) are widely prescribed to patients with liver cirrhosis. We hypothesized that long-standing PPI use is associated with spontaneous bacterial peritonitis (SBP) and accelerated development of disease-specific complications and liver-related death. METHODS: A 5-year follow-up observational cohort study assessed the impact of long-standing PPI use on the clinical course of cirrhosis in a large referral patient cohort. 350 patients with cirrhosis (males: 188, females: 162, ages: 56?6 years, alcohol: 242 [69.1%], Child-Pugh stage A/B/C: 206/108/36) were assigned to two groups: regular PPI users (n=196) and non-users (n=154). Occurrence of SBP, decompensation events (development of ascites, hepatic encephalopathy and variceal bleeding), and liver-related death were assessed. RESULTS: Regular PPI use was associated with an increased cumulative probability of SBP compared to non-users [CP: 55% vs 24.8%, HR: 4.25 (95%CI: 1.42-12.67), p=0.05], but only in patients who had no previous SBP episode (n=84). A similar association was found between regular PPI use and decompensation events. The risk of the development of a first decompensation event (ascites, HE or VB) was higher in regular PPI users compared to non-users, in patients with compensated clinical stage at enrollment (HR: 2.81, 95%CI: 1.31-6.01, p=0.008, n=146). The risk of liver-related death was also significantly increased among regular PPI users (p<0.001). In multivariate Cox-regression analysis, regular PPI use (HR: 2.81, 95%CI: 1.43-5.51, p=0.003) and MELD score (HR: 1.21, 95%CI: 1.08-1.35, p<0.001) was an independent predictor of mortality. In the present follow-up cohort study, long-term PPI use was associated with the development of SBP and a progressive disease course in patients with cirrhosis that may have been caused by enhanced pathologic BT, accelerated development of BT-dependent disease-specific complications, and liver-related death.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban proton pump inhibitors bacterial translocation spontaneous bacterial peritonitis disease progression mortality
Megjelenés:	European Journal of Gastroenterology & Hepatology. - 32 : 2 (2020), p. 257-264. -
További szerzők:	Tornai Tamás István (1984-) (belgyógyász) Borbély Brigitta Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00048 GINOP EFOP-3.6.1-16-2016-00022 EFOP EFOP-3.6.2-16-2017-00006 EFOP BO/00232/17/5 Egyéb ÚNKP-17-4 Egyéb
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001-es BibID:	BIBFORM058617
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Rediscovery of the anti-pancreatic antibodies and evaluation of their prognostic value in a prospective clinical cohort of Crohn's patients : the importance of specific target antigens (GP2 and CUZD1) / Maria Papp, Nora Sipeki, Tamas Tornai, Istvan Altorjay, Gary L. Norman, Zakera Shums, Dirk Roggenbuck, Kai Fechner, Winfried Stöcker, Peter Antal-Szalmas, Gabor Veres, Peter Laszlo Lakatos
Dátum:	2015
ISSN:	1873-9946
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban serologic antibodies anti-pancreatic antibodies glycoprotein CUZD1 glycoprotein 2 immunoglobulin A Crohn's disease ulcerative colitis disease progression
Megjelenés:	Journal of Crohns & Colitis. - 9 : 8 (2015), p. 659-668. -
További szerzők:	Sipeki Nóra (1987-) (általános orvos) Tornai Tamás István (1984-) (belgyógyász) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Norman, Gary L. Shums, Zakera Roggenbuck, Dirk Fechner, Kai Stocker, Winfried Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Veres Gábor (orvos) Lakatos Péter (Semmelweis Egyetem)
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001-es BibID:	BIBFORM045007
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	High prevalence of IgA class anti-neutrophil cytoplasmic antibodies (ANCA) is associated with increased risk of bacterial infection in patients with cirrhosis / Maria Papp, Nora Sipeki, Zsuzsanna Vitalis, Tamás Tornai, Istvan Altorjay, Istvan Tornai, Miklos Udvardy, Kai Fechner, Silvia Jacobsen, Bianca Teegen, Andrea Sumegi, Gabor Veres, Peter Laszlo Lakatos, Janos Kappelmayer, Peter Antal-Szalmas
Dátum:	2013
ISSN:	0168-8278
Megjegyzések:	Background&Aims: Anti-neutrophil cytoplasmic antibodies(ANCA) are a non-uniformfamily of antibodies recognizing diverse components of neutrophil granulocytes. ANCA formation might be induced by protracted bacterial infections or probably reflect an abnormal immune response to commensal microorganisms. Bacterial infections are common complications in cirrhosis with high incidence of episodes caused by enteric organisms, therefore, we sought to study the presence and clinical importance of ANCA in cirrhosis. Methods: Sera of 385 patients with cirrhosis of different etiologies were assayed for ANCA of IgG, IgA, IgA1, IgA2 and secretory IgA subtypes by indirect immunofluorescence and ELISAs. Control group comprised of 202 patients with chronic liver diseases without cirrhosis and 100 healthy subjects. In cirrhosis, a 2-year follow-up, observational study was conducted to assess possible association between presence of ANCA and clinically significant bacterial infections. Results: Prevalence of ANCA IgA was significantly higher in cirrhosis(52.2%) compared to chronic liver diseases(18.6%) or healthy controls (0%, p 0.001for both). ANCA IgA subtyping assays revealed marked increase in the proportion of IgA2 subtype (46% of total ANCA IgA) and presence of the secretory component concurrently. Presence of ANCA IgA was associated to disease-specific clinical characteristics (Child-Pugh stage and presence of ascites, p 0.001). During a 2-year follow-up period, risk of infectionswas higher among patients with ANCA IgA compared to those without (41.8% vs. 23.4%, p 0.001). ANCA IgA positivity was associated with a shorter time to the first infectiouscomplication (pLogRank0.001) in Kaplan?Meier analysis and was identified as anindependent predictor in multivariate Cox-regression analysis (HR:1.74, 95%CI:1.18?2.56, p=0.006). Conclusions: Presence of IgA type ANCA is common in cirrhosis. Involvement of gut mucosal immune system is in center of the formation and probably reflects sustained exposure to bacterial constituents.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban anti-neutrophil cytoplasmic antibodies cirrhosis bacterial infection
Megjelenés:	Journal of Hepatology. - 59 : 3 (2013), p. 457-466. -
További szerzők:	Sipeki Nóra (1987-) (általános orvos) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai Tamás István (1984-) (belgyógyász) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Udvardy Miklós (1947-) (belgyógyász, haematológus) Fechner, Kai Jacobsen, Silvia Teegen, Bianca Sümegi Andrea (1969-) (biológus) Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Lakatos Péter (Semmelweis Egyetem) Kappelmayer János (1960-) (laboratóriumi szakorvos) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
Pályázati támogatás:	T046694 OTKA TÁMOP-4.2.1./B-09/1/KONV-2010-0007 TÁMOP TÁMOP-4.2.2.A-11/1/KONV-2012-0025 TÁMOP
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