Konstantinos Soufleris

Lipoprotein-associated phospholipase A2 and arterial stiffness evaluation in patients with inflammatory bowel diseases

BACKGROUND AND AIMS The association between inflammatory bowel diseases (IBD) and cardiovascular disease (CVD) remains equivocal. Arterial stiffness, as assessed by pulse wave velocity (PWV), and lipoprotein-associated phospholipase A2 (Lp-PLA2) are surrogates of CVD risk. AIM The aim of this study was to assess carotid-femoral PWV and Lp-PLA2 in patients with IBD without history of CVD. METHODS Established CVD risk factors, IBD characteristics, PWV and Lp-PLA2 activity were assessed in 44 patients with IBD, 29 with Crohns disease (CD) and 15 with ulcerative colitis (UC), and 44 matched controls. RESULTS IBD patients had lower total and low density lipoprotein cholesterol (LDL-C) levels. There was no difference in PWV between patients and controls (6.8 vs. 6.4m/s), but patients with CD had higher PWV compared to those with UC (7 vs. 6.3m/s; p=0.044), and to controls. Smoking rates were significantly higher among CD patients. Factors associated with PWV were age, mean arterial pressure and smoking. Lp-PLA2 activity was significantly lower in patients with IBD (46.8 vs. 53.9 nmol/mL/min; p=0.011). There was no difference in Lp-PLA2 between CD and UC patients. LDL-C was the only significant predictor of Lp-PLA2. CONCLUSIONS Our study showed lower Lp-PLA2 activity in patients with IBD compared with controls, reflecting lower LDL-C in the former. There was no difference in PWV between the two groups. Arterial stiffness was higher in patients with CD, which is likely related to higher smoking rates. These findings challenge a possible association between IBD and CVD, but further studies are required.

Spur cells and spur cell anemia in hospitalized patients with advanced liver disease: Incidence and correlation with disease severity and survival.

Aim:  Spur cell anemia (SCA) is a form of acquired hemolytic anemia seen in patients with advanced cirrhosis and particularly in patients with alcoholic cirrhosis. The aim of the present study was to evaluate the incidence of spur cells and spur cell anemia in patients with advanced liver disease and to correlate the presence of spur cell anemia with survival.

Lamivudine/pegylated interferon alfa-2b sequential combination therapy compared with lamivudine monotherapy in HBeAg-negative chronic hepatitis B.

Background and Aim:  Monotherapy has been proven insufficient in achieving sustained control of chronic hepatitis B. We aimed to assess the efficacy of combined sequential administration of lamivudine and pegylated interferon alfa‐2b in patients with hepatitis Be antigen (HBeAg)‐negative chronic hepatitis B.

Active Helicobacter pylori infection is associated with colorectal mucosa – adenomatous polyp – early and advanced adenocarcinoma sequence

To the Editor, Shmuely et al. [1] concluded that Helicobacter pylori infection (Hp-I) serology is associated with advanced colorectal neoplasia (ACRN) development. They postulated that (a) opposing histology, serology may remain positive even after curing the infection, and the latter is an advantage, as the past infectionmay be even more important for oncogenesis; (b) the specific neoplasia colorectal location was not associated with Hp-I presence, though their data were not shown; and (c) a few possible physiopathological mechanisms for Hp-I and ACRN association include bacterial direct oncogenic effect or hypergastrinemia indirect trophic effect on colorectal mucosa. However, the serological test does not discriminate between current and past infections and, apart from past infection that might even be more relevant for oncogenesis, such a distinction is crucial because only current Hp-I induces humoral and cellular immune responses that induce or perpetuate chronic inflammatory processes in gastrointestinal tract with potential oncogenicsequelae;manymalignancies, includingcolorectal carcinoma (CRC), arise at the sites of chronic inflammation and infection [2,3]. Likewise, two recent large-scale relative epidemiologic studies also suggest that serologic measurement of infection status is less than perfect, thereby representing a limitation of their estimations [4,5]; one study [5] was also mentioned by the authors [1]. Basedonhistology, thegoldstandardforcurrentHp-I diagnosis, ourdata in 50CRCpatients, 25patientswith colorectal adenomas (CRAs) and 10 controls, showed significantly higher presence ofHp-I in theCRA (68%) andCRC (84%) groups comparedwith controls (30%) [6,7]; Hp presence was documented by immunohistochemical stain in colonic tissues.Our series also showed a tendency of increasedHppresence in left-sided (79%) compared with the proximal colon (21%) adenomas; left-sidedcancers(LSCs)wereobservedin64.3%ofour patients, a finding also noticed by others [4], thereby suggesting a possibleHp-I-related risk for LSC in some subpopulations. PresenceofHp-Iwith immunohistochemical expression of CD44 [cancer stem cells (CSCs) and/or bone marrow-derived stem cells (BMDSCs) indicator] was found in a high proportion of CRA patients with moderate-severe dysplasia (88%) and CRC patients with moderate-severe degree of malignancy

Idiopathic portal hypertension in an "inactive" HBV carrier: a case report.

Idiopathic portal hypertension belongs to the group of non-cirrhotic portal hypertension, its etiology is still unknown but its prognosis is excellent. We report a case of 45 year old female with inactive hepatitis B virus (HBV) carrier status and persistently elevated alpha-fetoprotein (AFP), presented with features of portal hypertension and without evidence of cirrhosis or fibrosis on liver biopsy.