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Renée E. Poupon - One of the best experts on this subject based on the ideXlab platform.

  • Biochemical markers of liver fibrosis and lymphocytic Piecemeal Necrosis in UDCA‐treated patients with primary biliary cirrhosis
    Liver International, 2004
    Co-Authors: Christophe Corpechot, Armelle Poujol-robert, Dominique Wendum, Marie Galotte, Yves Chrétien, Renée E. Poupon
    Abstract:

    : Background/Aim: We have previously shown that the histological stage and severity of lymphocytic Piecemeal Necrosis (LPN) are independent predictive factors of cirrhosis development in ursodeoxycholic acid (UDCA)-treated patients with primary biliary cirrhosis (PBC). Our aim during this study was to determine whether biochemical parameters classically used in PBC management and measured under UDCA could be considered as reliable surrogate markers for these histological prognostic indices in clinical practice. Method: The study included 153 patients with PBC who had undergone a control liver biopsy after 2 years of UDCA therapy. The relationships between histological and biological features were assessed by variance analysis and logistic regression. The diagnostic value of independent markers was assessed in terms of their sensitivity, specificity, positive predictive value (PPV) and negative value (NPV) and receiver-operating characteristic curves. Results: Two variables were independently associated with extensive fibrosis (i.e. advanced histological stages): serum levels of bilirubin and hyaluronic acid (HA). A fibrosis index ([bilirubin (μmol/l)/14]+[HA (μg/l)/143]) higher than 1.5 exhibited good PPV and specificity (>74%) but rather poor NPV and sensitivity ( 70%) but very low sensitivity (

  • biochemical markers of liver fibrosis and lymphocytic Piecemeal Necrosis in udca treated patients with primary biliary cirrhosis
    Liver International, 2004
    Co-Authors: Christophe Corpechot, Dominique Wendum, Marie Galotte, Yves Chrétien, Renée E. Poupon, Armelle Poujolrobert
    Abstract:

    : Background/Aim: We have previously shown that the histological stage and severity of lymphocytic Piecemeal Necrosis (LPN) are independent predictive factors of cirrhosis development in ursodeoxycholic acid (UDCA)-treated patients with primary biliary cirrhosis (PBC). Our aim during this study was to determine whether biochemical parameters classically used in PBC management and measured under UDCA could be considered as reliable surrogate markers for these histological prognostic indices in clinical practice. Method: The study included 153 patients with PBC who had undergone a control liver biopsy after 2 years of UDCA therapy. The relationships between histological and biological features were assessed by variance analysis and logistic regression. The diagnostic value of independent markers was assessed in terms of their sensitivity, specificity, positive predictive value (PPV) and negative value (NPV) and receiver-operating characteristic curves. Results: Two variables were independently associated with extensive fibrosis (i.e. advanced histological stages): serum levels of bilirubin and hyaluronic acid (HA). A fibrosis index ([bilirubin (μmol/l)/14]+[HA (μg/l)/143]) higher than 1.5 exhibited good PPV and specificity (>74%) but rather poor NPV and sensitivity ( 70%) but very low sensitivity (<25%) for a diagnosis of LPN. Conclusions: Serum bilirubin and HA levels measured under UDCA therapy are of acceptable diagnostic value for extensive fibrosis, but none of the biochemical tests commonly employed in the management of PBC can be considered as surrogate markers of LPN. Taken together with our previous results, these findings suggest that liver biopsy may be necessary to screen UDCA-treated patients who might require additional therapies.

  • Effect of the interaction between steatosis and alcohol intake on liver fibrosis progression in chronic hepatitis C.
    The American Journal of Gastroenterology, 2002
    Co-Authors: Lawrence Serfaty, Armelle Poujol-robert, Renée E. Poupon, Nicolas Carbonell, Olivier Chazouillères, Raoul Poupon
    Abstract:

    Abstract OBJECTIVES: Liver steatosis is a common histopathological finding in patients infected with hepatitis C virus. Patients with chronic hepatitis C having both steatosis and factors causing oxidative stress may be at a higher risk of fibrogenesis. In a subset of patients with a definite date of contamination, our study aimed to assess the potential synergistic interaction between steatosis and factors likely to induce oxidative stress—namely, alcohol intake, iron overload, and drugs. METHODS: Out of 700 anti-HCV-positive screened patients, 142 untreated patients with liver biopsy and with one known risk factor were selected. Liver fibrosis, inflammation, and Necrosis were graded according to the Knodell score, and steatosis as moderate to severe if more than 30% of hepatocytes were affected. Drinkers were defined as having daily mean alcohol intakes of more than 30 g in men and 20 g in women. RESULTS: In multivariate analysis, two factors were independently associated with extensive fibrosis: the degree of severity of Piecemeal Necrosis (OR = 3.27, CI = 1.17–9.16) and a combination of moderate to severe steatosis and alcohol intake (OR = 7.02, CI = 1.12–44). The median progression rate of fibrosis was about twice as high among drinkers with steatosis than among drinkers without steatosis or nondrinkers with or without steatosis (0.25 vs 0.1 vs 0.13 vs 0.08, respectively; p = 0.02). Independent parameters significantly associated with moderate to severe steatosis were body mass index (OR = 1.13, CI = 1.02–1.26) and infection with genotype 3 (OR = 5.5, CI = 1.88–16), but not alcohol consumption. CONCLUSIONS: As well as the key role of the severity of Piecemeal Necrosis, the study underlines the synergistic interaction between steatosis and even low alcohol consumption as a contributory factor in extensive liver fibrosis.

Yukihiko Adachi - One of the best experts on this subject based on the ideXlab platform.

  • circulating level of large splice variants of tenascin c is a marker of Piecemeal Necrosis activity in patients with chronic hepatitis c
    Liver International, 2006
    Co-Authors: Hideaki Tanaka, Amro Elkaref, Masahiko Kaito, Noriaki Kinoshita, Naoki Fujita, Shinichiro Horiike, Shozo Watanabe, Toshimichi Yoshida, Yukihiko Adachi
    Abstract:

    : Backgrounds: It has been reported that histological activity index and Piecemeal Necrosis are good factors to evaluate the prognosis in patients with chronic hepatitis C (CHC). Thus, there is a need for simple and noninvasive means to assess disease activity and Piecemeal Necrosis in patients with CHC. In this study, we measured the serum concentrations of large splice variants of tenascin-C (cTN-C) in patients with CHC, and examined their correlation with the degree of inflammatory activity and fibrosis as evaluated in liver biopsy specimens. Methods: The serum levels of cTN-C in 150 patients with CHC and 50 healthy volunteers were measured by enzyme-linked immunosorbent. The histology of liver biopsy specimens was also evaluated following the Desmet's grading/staging system and the Ishak's classification. Liver specimens obtained by biopsy were also immunohistochemically evaluated with anti-human tenascin-C antibodies. Results: Serum cTN-C concentrations were significantly higher in CHC patients than in healthy volunteers (P<0.0001). The levels of cTN-C showed no significant difference among the fibrosis stages as assessed by the Desmet's grading/staging system and Ishak's classification scores. However, the concentration of cTN-C was significantly correlated with the grade of activity. According to the Ishak's classification, the concentration of cTN-C was increased in proportion to the degree of Piecemeal Necrosis. Specific immunostaining of cTN-C was observed in limited areas of Piecemeal Necrosis but not in fibrotic areas. Conclusion: The measurement of serum levels of cTN-C is a useful marker of the activity of CHC, in particular of the degree of Piecemeal Necrosis.

  • Circulating level of large splice variants of tenascin-C is a marker of Piecemeal Necrosis activity in patients with chronic hepatitis C
    Liver International, 2006
    Co-Authors: Hideaki Tanaka, Masahiko Kaito, Noriaki Kinoshita, Naoki Fujita, Shinichiro Horiike, Shozo Watanabe, Toshimichi Yoshida, Amro El-karef, Yukihiko Adachi
    Abstract:

    : Backgrounds: It has been reported that histological activity index and Piecemeal Necrosis are good factors to evaluate the prognosis in patients with chronic hepatitis C (CHC). Thus, there is a need for simple and noninvasive means to assess disease activity and Piecemeal Necrosis in patients with CHC. In this study, we measured the serum concentrations of large splice variants of tenascin-C (cTN-C) in patients with CHC, and examined their correlation with the degree of inflammatory activity and fibrosis as evaluated in liver biopsy specimens. Methods: The serum levels of cTN-C in 150 patients with CHC and 50 healthy volunteers were measured by enzyme-linked immunosorbent. The histology of liver biopsy specimens was also evaluated following the Desmet's grading/staging system and the Ishak's classification. Liver specimens obtained by biopsy were also immunohistochemically evaluated with anti-human tenascin-C antibodies. Results: Serum cTN-C concentrations were significantly higher in CHC patients than in healthy volunteers (P

Masamichi Kojiro - One of the best experts on this subject based on the ideXlab platform.

  • influence of Piecemeal Necrosis on the compensatory increase of mitochondrial respiratory enzymes of the tumour bearing liver clinical study of 53 surgical cases
    Journal of Gastroenterology and Hepatology, 1990
    Co-Authors: Atsuhiko Maki, Yoshiharu Sakai, Akira Tanaka, Yoshio Yamaoka, Kazue Ozawa, Masayoshi Kage, Masamichi Kojiro
    Abstract:

    The relationships between histological findings, adaptively increased cytochrome a(+a3) levels in chronic liver disease and complications after hepatectomy were studied in order to clarify the mechanism of mitochondrial derangement. The liver specimens of 53 hepatectomized patients were randomly evaluated by three independent hepatopathologists and were compared with cytochrome a(+a3) levels in the biopsied liver, the extent of operation and postoperative complications. The cytochrome a(+a3) concentrations did not show any significant difference between cases of chronic hepatitis and liver cirrhosis nor groups classified by regeneration. Severity of Piecemeal Necrosis was categorized into three groups: group A—minimal (n= 20); group B—moderate (n= 19); and group C—severe (n= 14). There were significant differences (P < 0.01) in cytochrome a(+a3) concentrations between the groups (A: 99 ± 9; B: 135 ± 6; C: 155 ± 10 pmol/mg of mitochondrial protein). Extensive hepatectomy, involving segmentectomy or more, was frequently complicated (four of nine, 44.4%) in group C, whereas there were few complications (two of 16, 12.5%) in group A cases in which extensive hepatectomy was performed. Evidence will be presented which will show that deranged liver function, as indicated by cytochrome a(+a3) levels, is closely correlated with Piecemeal Necrosis. This may be attributed to the damage of periportal hepatocytes which are the main sites of oxidative phosphorylation.

  • Influence of Piecemeal Necrosis on the compensatory increase of mitochondrial respiratory enzymes of the tumour‐bearing liver: Clinical study of 53 surgical cases
    Journal of Gastroenterology and Hepatology, 1990
    Co-Authors: Atsuhiko Maki, Yoshiharu Sakai, Akira Tanaka, Yoshio Yamaoka, Kazue Ozawa, Masayoshi Kage, Masamichi Kojiro
    Abstract:

    The relationships between histological findings, adaptively increased cytochrome a(+a3) levels in chronic liver disease and complications after hepatectomy were studied in order to clarify the mechanism of mitochondrial derangement. The liver specimens of 53 hepatectomized patients were randomly evaluated by three independent hepatopathologists and were compared with cytochrome a(+a3) levels in the biopsied liver, the extent of operation and postoperative complications. The cytochrome a(+a3) concentrations did not show any significant difference between cases of chronic hepatitis and liver cirrhosis nor groups classified by regeneration. Severity of Piecemeal Necrosis was categorized into three groups: group A—minimal (n= 20); group B—moderate (n= 19); and group C—severe (n= 14). There were significant differences (P < 0.01) in cytochrome a(+a3) concentrations between the groups (A: 99 ± 9; B: 135 ± 6; C: 155 ± 10 pmol/mg of mitochondrial protein). Extensive hepatectomy, involving segmentectomy or more, was frequently complicated (four of nine, 44.4%) in group C, whereas there were few complications (two of 16, 12.5%) in group A cases in which extensive hepatectomy was performed. Evidence will be presented which will show that deranged liver function, as indicated by cytochrome a(+a3) levels, is closely correlated with Piecemeal Necrosis. This may be attributed to the damage of periportal hepatocytes which are the main sites of oxidative phosphorylation.

Christophe Corpechot - One of the best experts on this subject based on the ideXlab platform.

  • Biochemical markers of liver fibrosis and lymphocytic Piecemeal Necrosis in UDCA‐treated patients with primary biliary cirrhosis
    Liver International, 2004
    Co-Authors: Christophe Corpechot, Armelle Poujol-robert, Dominique Wendum, Marie Galotte, Yves Chrétien, Renée E. Poupon
    Abstract:

    : Background/Aim: We have previously shown that the histological stage and severity of lymphocytic Piecemeal Necrosis (LPN) are independent predictive factors of cirrhosis development in ursodeoxycholic acid (UDCA)-treated patients with primary biliary cirrhosis (PBC). Our aim during this study was to determine whether biochemical parameters classically used in PBC management and measured under UDCA could be considered as reliable surrogate markers for these histological prognostic indices in clinical practice. Method: The study included 153 patients with PBC who had undergone a control liver biopsy after 2 years of UDCA therapy. The relationships between histological and biological features were assessed by variance analysis and logistic regression. The diagnostic value of independent markers was assessed in terms of their sensitivity, specificity, positive predictive value (PPV) and negative value (NPV) and receiver-operating characteristic curves. Results: Two variables were independently associated with extensive fibrosis (i.e. advanced histological stages): serum levels of bilirubin and hyaluronic acid (HA). A fibrosis index ([bilirubin (μmol/l)/14]+[HA (μg/l)/143]) higher than 1.5 exhibited good PPV and specificity (>74%) but rather poor NPV and sensitivity ( 70%) but very low sensitivity (

  • biochemical markers of liver fibrosis and lymphocytic Piecemeal Necrosis in udca treated patients with primary biliary cirrhosis
    Liver International, 2004
    Co-Authors: Christophe Corpechot, Dominique Wendum, Marie Galotte, Yves Chrétien, Renée E. Poupon, Armelle Poujolrobert
    Abstract:

    : Background/Aim: We have previously shown that the histological stage and severity of lymphocytic Piecemeal Necrosis (LPN) are independent predictive factors of cirrhosis development in ursodeoxycholic acid (UDCA)-treated patients with primary biliary cirrhosis (PBC). Our aim during this study was to determine whether biochemical parameters classically used in PBC management and measured under UDCA could be considered as reliable surrogate markers for these histological prognostic indices in clinical practice. Method: The study included 153 patients with PBC who had undergone a control liver biopsy after 2 years of UDCA therapy. The relationships between histological and biological features were assessed by variance analysis and logistic regression. The diagnostic value of independent markers was assessed in terms of their sensitivity, specificity, positive predictive value (PPV) and negative value (NPV) and receiver-operating characteristic curves. Results: Two variables were independently associated with extensive fibrosis (i.e. advanced histological stages): serum levels of bilirubin and hyaluronic acid (HA). A fibrosis index ([bilirubin (μmol/l)/14]+[HA (μg/l)/143]) higher than 1.5 exhibited good PPV and specificity (>74%) but rather poor NPV and sensitivity ( 70%) but very low sensitivity (<25%) for a diagnosis of LPN. Conclusions: Serum bilirubin and HA levels measured under UDCA therapy are of acceptable diagnostic value for extensive fibrosis, but none of the biochemical tests commonly employed in the management of PBC can be considered as surrogate markers of LPN. Taken together with our previous results, these findings suggest that liver biopsy may be necessary to screen UDCA-treated patients who might require additional therapies.

Hideaki Tanaka - One of the best experts on this subject based on the ideXlab platform.

  • circulating level of large splice variants of tenascin c is a marker of Piecemeal Necrosis activity in patients with chronic hepatitis c
    Liver International, 2006
    Co-Authors: Hideaki Tanaka, Amro Elkaref, Masahiko Kaito, Noriaki Kinoshita, Naoki Fujita, Shinichiro Horiike, Shozo Watanabe, Toshimichi Yoshida, Yukihiko Adachi
    Abstract:

    : Backgrounds: It has been reported that histological activity index and Piecemeal Necrosis are good factors to evaluate the prognosis in patients with chronic hepatitis C (CHC). Thus, there is a need for simple and noninvasive means to assess disease activity and Piecemeal Necrosis in patients with CHC. In this study, we measured the serum concentrations of large splice variants of tenascin-C (cTN-C) in patients with CHC, and examined their correlation with the degree of inflammatory activity and fibrosis as evaluated in liver biopsy specimens. Methods: The serum levels of cTN-C in 150 patients with CHC and 50 healthy volunteers were measured by enzyme-linked immunosorbent. The histology of liver biopsy specimens was also evaluated following the Desmet's grading/staging system and the Ishak's classification. Liver specimens obtained by biopsy were also immunohistochemically evaluated with anti-human tenascin-C antibodies. Results: Serum cTN-C concentrations were significantly higher in CHC patients than in healthy volunteers (P<0.0001). The levels of cTN-C showed no significant difference among the fibrosis stages as assessed by the Desmet's grading/staging system and Ishak's classification scores. However, the concentration of cTN-C was significantly correlated with the grade of activity. According to the Ishak's classification, the concentration of cTN-C was increased in proportion to the degree of Piecemeal Necrosis. Specific immunostaining of cTN-C was observed in limited areas of Piecemeal Necrosis but not in fibrotic areas. Conclusion: The measurement of serum levels of cTN-C is a useful marker of the activity of CHC, in particular of the degree of Piecemeal Necrosis.

  • Circulating level of large splice variants of tenascin-C is a marker of Piecemeal Necrosis activity in patients with chronic hepatitis C
    Liver International, 2006
    Co-Authors: Hideaki Tanaka, Masahiko Kaito, Noriaki Kinoshita, Naoki Fujita, Shinichiro Horiike, Shozo Watanabe, Toshimichi Yoshida, Amro El-karef, Yukihiko Adachi
    Abstract:

    : Backgrounds: It has been reported that histological activity index and Piecemeal Necrosis are good factors to evaluate the prognosis in patients with chronic hepatitis C (CHC). Thus, there is a need for simple and noninvasive means to assess disease activity and Piecemeal Necrosis in patients with CHC. In this study, we measured the serum concentrations of large splice variants of tenascin-C (cTN-C) in patients with CHC, and examined their correlation with the degree of inflammatory activity and fibrosis as evaluated in liver biopsy specimens. Methods: The serum levels of cTN-C in 150 patients with CHC and 50 healthy volunteers were measured by enzyme-linked immunosorbent. The histology of liver biopsy specimens was also evaluated following the Desmet's grading/staging system and the Ishak's classification. Liver specimens obtained by biopsy were also immunohistochemically evaluated with anti-human tenascin-C antibodies. Results: Serum cTN-C concentrations were significantly higher in CHC patients than in healthy volunteers (P