Reduced lysosomal acid lipase activity in blood and platelets is associated with nonalcoholic fatty liver disease

OBJECTIVES: To investigate whether blood total lysosomal acid lipase activity (BT-LAL) levels are uniquely associated with the noncirrhotic and cirrhotic stages of nonalcoholic fatty liver disease (NAFLD) and with protection from NAFLD in metabolically/genetically predisposed subjects and a normal liver. To clarify which enzyme-carrying circulating cells are involved in reduced BT-LAL of NAFLD.METHODS: In a cross-sectional study, BT-LAL was measured by a fluorigenic method in patients with NAFLD (n = 118), alcoholic (n = 116), and hepatitis C virus-related disease (n = 49), in 103 controls with normal liver and in 58 liver transplant recipients. Intracellular platelet and leukocyte LAL was measured in 14 controls and 28 patients with NAFLD.RESULTS: Compared with controls, (i) BT-LAL and LAL in platelets, but not in leukocytes, were progressively reduced in noncirrhotic NAFLD and in nonalcoholic steatohepatitis-related cirrhosis; (ii) platelet and leukocyte counts did not differ in patients with noncirrhotic NAFLD; and (iii) BT-LAL did not differ in alcoholic and hepatitis C virus noncirrhotic patients. BT-LAL progressively increased in controls with metabolic syndrome features according to their PNPLA3 rs738409 steatosis-associated variant status (II vs IM vs MM), and their BT-LAL was higher than that of noncirrhotic NAFLD, only when carriers of the PNPLA3 unfavorable alleles were considered. Liver transplant recipients with de novo NAFLD compared with those without de novo NAFLD had lower BT-LAL.DISCUSSION: LAL in blood and platelets is progressively and uniquely reduced in NAFLD according to disease severity. High BT-LAL is associated with protection from NAFLD occurrence in subjects with metabolic and genetic predisposition. Low LAL in platelets and blood could play a pathogenetic role in NAFLD

Microbial contamination and sick building syndrome

Permanence within a building is frequently associated with health complaints identified as several clinical syndromes. Contamination by bacterial products may play a predominant role in some of these clinical syndromes, like building-related asthma, humidifier fever or the sick building syndrome (SBS). Indeed, on one side, in air-conditioned systems, the physical conditions are optimal for microbial development and for endotoxin production (from the membrane of gram negative bacteria) and on the other side, inhalation of endotoxin has demonstrated the onset of a bronchial obstruction and an increase in airway reactivity leading to non specific chest complaints. Nevertheless, this hypothesis on aetiopathogenesis of SBS remains to be demonstrated by environmental and lung functional studies on the building site. © 1990 Kluwer Academic Publishers.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Protective effect of sodium cromoglycate on lipopolysaccharide-induced bronchial obstruction in asthmatics

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Characteristics of the bronchial obstructive response induced by inhalation of endotoxins

SCOPUS: cp.jinfo:eu-repo/semantics/publishe

Effect of endotoxin contamination on the antigenic skin test response

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Inflammatory response to acute inhalation of endotoxin in asthmatic patients

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Estrogen receptors in cholangiocytes and the progression of primary biliary cirrhosis

Background/Aims: Estrogen receptors (ER) in cholangiocytes of primary biliary cirrhosis (PBC) patients and their relationship with cell proliferation and death were evaluated. Methods: Liver biopsies from PBC patients with different histological stages were investigated by immunohistochemistry for ER-alpha and -beta, cytokeratin-19, proliferating cellular nuclear antigen (PCNA), Fas and terminal deoxynucleotide transferase end labelling (TUNEL). Normal livers and livers from primary sclerosing cholangitis and alcoholic cirrhosis were investigated as controls. Results: ER-alpha and -beta were observed in cholangiocytes of PBC patients but not in normal liver. In PBC, positivity for ER-beta was high (50-65 %) in all histological stages while, positivity for ER-alpha increased from 1 % in stage I to 12 % in stage III (positivity correlated and co-localized in the same cell with PCNA). In stage IV of PBC, cholangiocytes were negative for ER-alpha in association with a lower PCNA positivity and with maximal degree of ductopenia. ER-alpha positivity in cholangiocytes of PBC patients was markedly lower than primary sclerosing cholangitis and alcoholic cirrhosis. Conclusions: ER are expressed in PBC and other pathologies associated with cholangiocyte proliferation but not in normal subjects. The low expression of ER-alpha in PBC and their disappearance in the advanced histological stages suggests that an estrogenic deficiency could favour the evolution of this disease toward ductopenia. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved

Electronic outpatient referral system for liver transplant improves appropriateness and allows first visit triage

Missed or inappropriate referrals of potential candidates for liver transplantation (LT) are common and traditional referral methods (tRs) do not allow for efficient triage. We investigated the effects on these issues of a website developed for electronic oupatient referral to LT (eRW-LT) METHODS: We prospectively collected data on all consecutive outpatient referrals to two Italian LT centers from January 2015 to December 2019. In the second half of the study, starting from July 2017, referring physicians had the option of using eRW-LT, quickly obtaining the judgment on the appropriateness and urgency of the visit from a transplant hepatologist