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Journal of Gastroenterology and... May 2024Primary biliary cholangitis (PBC) is an autoimmune-mediated cholestatic liver disease that can progress to biliary cirrhosis and liver-related death. The associations...
BACKGROUND AND AIM
Primary biliary cholangitis (PBC) is an autoimmune-mediated cholestatic liver disease that can progress to biliary cirrhosis and liver-related death. The associations between baseline myostatin levels and clinical outcomes in PBC patients are unknown. We aimed to clarify the influence of myostatin levels on the clinical outcomes of PBC patients.
METHODS
A total of 119 PBC patients were analyzed in this study. Myostatin levels were measured in stored sera before ursodeoxycholic acid treatment, and their associations with the clinical features and prognosis of PBC patients were analyzed. We analyzed the correlation between serum myostatin and chemokines/cytokines.
RESULTS
Serum myostatin was significantly lower in PBC patients (2343 pg/mL) than in healthy controls (4059 pg/mL, P < 0.001). The prevalence of patients with low myostatin levels increased according to the severity of histological fibrosis. The serum myostatin concentration was negatively correlated with the IL-6 and leucine-rich α2 glycoprotein levels, but the chemokine concentration was not correlated with the myostatin concentration. Low myostatin in PBC patients was associated with shorter survival without liver-related complications (hazard ratio [HR], 3.598; 95% confidence interval [CI], 1.27-10.1; P = 0.015) and shorter transplant-free survival (HR, 3.129; 95% CI, 1.02-9.56; P = 0.045) independent of pretreatment GLOBE score. Patients with both high pretreatment GLOBE scores and low myostatin levels had poor prognoses (log-rank test: P < 0.001).
CONCLUSIONS
A low serum myostatin concentration at diagnosis was associated with poor clinical outcomes. Assessment of circulating myostatin levels may improve the prediction of outcomes in patients with PBC.
PubMed: 38816894
DOI: 10.1111/jgh.16639 -
Transplantation Proceedings May 2024Caroli disease (CD) is a congenital disease of the intrahepatic biliary system, which manifests as cystic dilatation of the intrahepatic bile ducts. The disease has a...
Caroli disease (CD) is a congenital disease of the intrahepatic biliary system, which manifests as cystic dilatation of the intrahepatic bile ducts. The disease has a low incidence and atypical clinical manifestations; therefore, it can be easily misdiagnosed. Hepatitis B infection is a viral infection that affects liver cells, leading to degeneration, necrosis, and regeneration of the cells and formation of false lobules, and ultimately nodular cirrhosis, which can lead to liver dysfunction and liver failure. Herein, we report a case of decompensated liver cirrhosis because of a diffuse form of CD, which was misdiagnosed because of long-term hepatitis B virus (HBV) infection. Finally, orthotopic liver transplantation (OLT) was performed, and the patient was cured. We believe that this congenital factor combined with HBV infection accelerated cirrhosis progression in this patient. This transplant was carried out in accordance with the Helsinki Congress and the Declaration of Istanbul.
PubMed: 38816291
DOI: 10.1016/j.transproceed.2024.05.012 -
Surgery May 2024The impact of cirrhosis on the postoperative outcomes of distal pancreatectomy is yet to be reported. We aimed to evaluate the outcomes of distal pancreatectomy in...
BACKGROUND
The impact of cirrhosis on the postoperative outcomes of distal pancreatectomy is yet to be reported. We aimed to evaluate the outcomes of distal pancreatectomy in patients with cirrhosis.
METHODS
We conducted a retrospective, multicentric study patients with cirrhosis who underwent planned distal pancreatectomy between 2008 and 2020 in French high volume centers. Patients with cirrhosis were matched 1:4 for demographic, surgical, and histologic criteria with patients without cirrhosis. The primary endpoint was severe morbidity (Clavien-Dindo grade ≥III). The secondary endpoints were postoperative complications, specifically related to cirrhosis and pancreatic surgery, and survival for patients with pancreatic adenocarcinoma.
RESULTS
Overall, 32 patients with cirrhosis were matched with 128 patients without cirrhosis. Most patients (93.5%) had Child-Pugh A cirrhosis. The severe morbidity rate after distal pancreatectomy was higher in patients with cirrhosis than in those without cirrhosis (28.13% vs 25.75%, P = .11. The operative time was significantly longer in the cirrhotic group compared with controls (P = .01). However, patients with and without cirrhosis had comparable blood loss and conversion rates. Postoperatively, the two groups had similar rates of pancreatic fistula, hemorrhage, reoperation, postoperative mortality, and survival rates at 1, 3, and 5 years.
CONCLUSION
The current study suggests that distal pancreatectomy in high-volume centers is feasible for patients with compensated cirrhosis.
PubMed: 38811323
DOI: 10.1016/j.surg.2024.03.038 -
The New England Journal of Medicine May 2024
Topics: Humans; Liver Cirrhosis, Biliary; Clinical Trials, Phase III as Topic
PubMed: 38810196
DOI: 10.1056/NEJMc2403986 -
The New England Journal of Medicine May 2024
Topics: Humans; Liver Cirrhosis, Biliary; Clinical Trials, Phase III as Topic
PubMed: 38810195
DOI: 10.1056/NEJMc2403986 -
The New England Journal of Medicine May 2024
Topics: Humans; Liver Cirrhosis, Biliary; Drug Therapy, Combination
PubMed: 38810194
DOI: 10.1056/NEJMc2403986 -
The New England Journal of Medicine May 2024
Topics: Humans; Liver Cirrhosis, Biliary; Drug Therapy, Combination
PubMed: 38810193
DOI: 10.1056/NEJMc2403986 -
International Journal of General... 2024[This retracts the article DOI: 10.2147/IJGM.S11201.].
[This retracts the article DOI: 10.2147/IJGM.S11201.].
PubMed: 38803553
DOI: 10.2147/IJGM.S479426 -
Alimentary Pharmacology & Therapeutics May 2024
PubMed: 38803269
DOI: 10.1111/apt.18044 -
Alimentary Pharmacology & Therapeutics May 2024
PubMed: 38803242
DOI: 10.1111/apt.18067