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001-es BibID:	BIBFORM073777
Első szerző:	Pályu Eszter
Cím:	Major changes of von Willebrand factor multimer distribution in cirrhotic patients with stable disease or acute decompensation / Eszter Palyu, Jolan Harsfalvi, Tamas Tornai, Maria Papp, Miklos Udvardy, Katalin Szekeres-Csiki, Lajos Pataki, Karen Vanhoorelbeke, Hendrik B. Feys, Hans Deckmyn, Istvan Tornai
Dátum:	2018
ISSN:	0340-6245
Megjegyzések:	Background and aims: There is an unstable balance between pro- and anti-haemostatic processes in patients with cirrhosis. We hypothesized, that in patients with acute decompensation (AD) the major alterations of von Willebrand factor (VWF) could contribute to the prothrombotic situation as compared to patients with stable (ST) cirrhosis. Methods: We analyzed different parameters of VWF, including detailed multimer distribution by densitometry and platelet adhesion together with ADAMTS13 activity and antigen and C-reactive protein (CRP) levels in patients with ST (n=99), with AD (n=54) and controls (n=92). Results: VWF antigen, ristocetin cofactor as well as collagen binding activities were elevated in both cirrhotic groups in a stepwise manner. There was a decrease in high and an increase in low molecular weight multimer ratios in the majority of ST cirrhosis. However, in 24 out of 54 AD patients ultra-large VWF multimers (ULMWM) were found. ADAMTS13 activity in ST and AD patients without ULMWM was similar to controls [median, (IQR)%: 98 (67-132) and 91 (60-110) vs. 106 (88-117), respectively]. The presence of ULMWM in AD patients was associated with low ADAMTS13 activity [33 (24-49)%] and high CRP level [23 (7.1-83.6)mg/l]. Adhesion of normal platelets showed a stepwise increase in the presence of cirrhotic plasmas, reaching the highest level in AD patients with ULMWM. Conclusion: Characteristic changes of VWF parameters are seen in ST cirrhosis. In AD patients highly increased VWF and reduced ADAMTS13 activity could be found, along with the presence of ULMWM, which are possible markers and contributors of the disease progression.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban cirrhosis acute decompensation systemic inflammation von Willebrand factor multimers trhombotic microangiopathy
Megjelenés:	Thrombosis and Haemostasis. - 118 : 8 (2018), p. 1397-1408. -
További szerzők:	Hársfalvi Jolán (1949-) (klinikai biokémikus) Tornai Tamás István (1984-) (belgyógyász) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Udvardy Miklós (1947-) (belgyógyász, haematológus) Szekeres-Csiki Katalin (1979-) (orvos) Pataki Lajos Vanhoorelbeke, Karen Feys, Hendrik B. Deckmyn, Hans Tornai István (1954-) (belgyógyász, gasztroenterológus)
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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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