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001-es BibID:	BIBFORM019953
Első szerző:	Lakatos Péter (Semmelweis Egyetem)
Cím:	Serum lipopolysaccharide-binding protein and soluble CD14 are markers of disease activity in patients with Crohn's disease / Lakatos P. L., Kiss L. S., Palatka K., Altorjay I., Antal-Szalmas P., Palyu E., Udvardy M., Molnar T., Farkas K., Veres G., Harsfalvi J., Papp J., Papp M.
Dátum:	2011
Megjegyzések:	In inflammatory bowel disease (IBD), enhanced inflammatory activity in the gut is thought to increase the risk of bacterial translocation and endotoxemia. In the present study we investigated the association between serum level of lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14), and clinical disease activity, high-sensitivity C-reactive protein (hs-CRP), antimicrobial serology profile, NOD2/CARD15 status, and clinical phenotype in a large cohort of Hungarian Crohn's disease (CD) patients. METHODS: In all, 214 well-characterized, unrelated, consecutive CD patients (male/female ratio: 95/119; age: 35.6 ± 13.1 years; duration:8.3 ± 7.5 years) and 110 healthy controls were investigated. Sera were assayed for LBP, sCD14, hs-CRP, ASCA IgG/IgA, anti-OMP IgA, and pANCA antibodies. NOD2/CARD15 and TLR4 variants were tested. Detailed clinical phenotypes were determined by reviewing the patients' medical charts. RESULTS: Serum LBP level was significantly higher (P < 0.0001 for both), while sCD14 was lower (P < 0.0001) in both active and inactive CD compared to the controls. The accuracy of hs-CRP (area under the curve [AUC] = 0.66), sCD14 (AUC = 0.70), and LBP (AUC = 0.58) was comparable for identifying patients with active disease. There was a significant correlation between LBP (P < 0.001), sCD14 (P = 0.015), and hs-CRP levels but not with antimicrobial seroreactivity or NOD2/CARD15 genotype. In inactive CD, LBP was associated with penetrating disease. In a Kaplan-Meier analysis and a proportional Cox-regression analysis, LBP (P = 0.006), sCD14 (P = 0.007), and previous relapse frequency (P = 0.023) were independently associated with time to clinical relapse during a 12-month follow-up period. CONCLUSIONS: Serum LBP and sCD14 are markers of disease activity in CD with a similar accuracy as hs-CRP. In addition, LBP, sCD14, and a high frequency of previous relapses were independent predictors for 1-year clinical flare-up. (Inflamm Bowel Dis 2011).
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban egyetemen (Magyarországon) készült közlemény
Megjelenés:	Inflammatory Bowel Disease. - 17 : 3 (2011), p. 767-777. -
További szerzők:	Kiss Lajos Sándor Palatka Károly (1961-) (belgyógyász, gasztroenterológus) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Pályu Eszter (1983-) Udvardy Miklós (1947-) (belgyógyász, haematológus) Molnár Tamás (orvos Szeged) Farkas Klaudia Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Hársfalvi Jolán (1949-) (klinikai biokémikus) Papp János (Budapest) Papp Mária (1975-) (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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