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‣ Terapia hormonal em mulheres na pós-menopausa com hepatite crônica pelo vírus C; Hormone therapy in postmenopausal women with chronic viral hepatitis C

Pádua, Márcia Aparecida de Faria
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 03/07/2007 Português
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OBJETIVO: Analisar a sintomatologia climatérica, a função hepática e a hemostasia das pacientes com hepatite crônica pelo vírus C, durante o uso da terapia hormonal. METODOLOGIA: As pacientes foram divididas em dois grupos: Grupo TH (Grupo caso) - 25 pacientes com terapia hormonal transdérmica (50mcg de estradiol e 170 mcg de noretisterona/dia) por 9 meses, e Grupo NT (Grupo controle) - 25 pacientes sem terapia hormonal, ambos com sintomas climatéricos. A menopausa foi confirmada pela dosagem do FSH, LH e estradiol, e a hepatite C foi diagnosticada pela sorologia, PCR (reação em cadeia de polimerase) e biópsia hepática (grau histológico variando de I-IV). Os dois grupos foram avaliados no mês 0, 1,4,7 e 9; sendo a sintomatologia climatérica mensurada através do Índice Menopausal de Kupperman, a função hepática e a hemostasia pelos exames: alanina aminotransferase, aspartato aminotransferase, gama glutamiltransferase, fosfatase alcalina, bilirrubinas, albumina, tempo de protrombina, fator V, fibrinogênio e plaquetas. ANÁLISE ESTATÍSTICA: realizada através do teste t de Student, teste de Mann Whitney e análises de variâncias com medidas repetidas com dois fatores. Após a realização das análises de variâncias...

‣ Autoantibodies before, during and after administration of recombinant interferon-alpha for chronic viral hepatitis

Lopes,Edmundo P.A.; Silva,A. Eduardo; Sette Junior,Hoel; Guimarães,Rubens X.; Ferraz,M. Lucia
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/1995 Português
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This study was undertaken to investigate the presence of autoantibodies in patients with chronic viral hepatitis B and C, before, during and after interferon-alpha (IFN-alpha) therapy and to study their relation to dose and type of IFN-alpha and response to treatment. Fifty patients with chronic hepatitis were divided in two groups, a control-group of 21 patients (10 type B and 11 type C) who were followed for 6 months without treatment and an IFN-group consisting of 29 patients (8 type B and 21 type C) who received IFN therapy for 6 months. Serum samples were tested for a range of antibodies at the start of the study, during therapy and at the end of the 6 month period. Antibodies tested for included: antinuclear, smooth muscle, antimitochondrial, parietal cell and thyroid microsomal. Four (8%) of the total patient group had autoantibodies at the beginning of the study (two in each group). During the follow-up period no patient in the control group developed antibodies compared with 3 (11%) patients in the treatment group. Autoantibodies developed in patients treated with higher doses of IFN and were found in those patients who tended to show a poor response to IFN-therapy. Further studies are needed to establish the relationship between poor response to IFN-alpha and development of autoantibodies.

‣ The influence of the human genome on chronic viral hepatitis outcome

Andrade Júnior,Dahir Ramos de; Andrade,Dahir Ramos de
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2004 Português
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The mechanisms that determine viral clearance or viral persistence in chronic viral hepatitis have yet to be identified. Recent advances in molecular genetics have permitted the detection of variations in immune response, often associated with polymorphism in the human genome. Differences in host susceptibility to infectious disease and disease severity cannot be attributed solely to the virulence of microbial agents. Several recent advances concerning the influence of human genes in chronic viral hepatitis B and C are discussed in this article: a) the associations between human leukocyte antigen polymorphism and viral hepatic disease susceptibility or resistance; b) protective alleles influencing hepatitis B virus (HBV) and hepatitis C virus (HCV) evolution; c) prejudicial alleles influencing HBV and HCV; d) candidate genes associated with HBV and HCV evolution; d) other genetic factors that may contribute to chronic hepatitis C evolution (genes influencing hepatic stellate cells, TGF-beta1 and TNF-alpha production, hepatic iron deposits and angiotensin II production, among others). Recent discoveries regarding genetic associations with chronic viral hepatitis may provide clues to understanding the development of end-stage complications such as cirrhosis or hepatocellular carcinoma. In the near future...

‣ Coexpression of intercellular adhesion molecule-1 and class I major histocompatibility complex antigens on hepatocyte membrane in chronic viral hepatitis.

Chu, C M; Liaw, Y F
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1993 Português
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AIMS--To evaluate the role of hepatocyte expression of leucocyte adhesion molecules and major histocompatibility complex (MHC) antigens in the pathogenesis of chronic viral hepatitis. METHODS--The expression of intercellular adhesion molecule 1 (ICAM-1), lymphocyte function associated antigen 3 (LFA-3), and MHC class I and II antigens on hepatocyte membrane in relation to the histological and biochemical activities was studied in patients with chronic B hepatitis, chronic persistent hepatitis (CPH) n = 23; chronic active hepatitis (CAH) n = 20; chronic D hepatitis (CAH) n = 6; and chronic non-A, non-B hepatitis (CPH n = 4, CAM n = 6). Six of the latter were hepatitis C virus antibody positive. RESULTS--In chronic B hepatitis ICAM-1 and MHC-I were expressed significantly more in patients with CAH than in those with CPH (p < 0.001), while the expression of LFA-3 and MHC-II showed no significant difference, irrespective of serum HBeAg or hepatitis B virus DNA. Similar findings were noted in non-A, non-B hepatitis. Regardless of the viral aetiology, patients with CAH had a significantly higher degree of ICAM-1 and MHC-I expression than LFA-3 (p < 0.001 v ICAM-1 and MHC-I, respectively) and MHC-II (p < 0.001 v ICAM-1 and MHC-I, respectively) expression. Those with CPH showed little or no difference in the expression of these four molecules. Furthermore...

‣ Inducible nitric oxide synthase expression in chronic viral hepatitis. Evidence for a virus-induced gene upregulation.

Majano, P L; García-Monzón, C; López-Cabrera, M; Lara-Pezzi, E; Fernández-Ruiz, E; García-Iglesias, C; Borque, M J; Moreno-Otero, R
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 01/04/1998 Português
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Increased nitric oxide (NO) production may contribute to the pathological changes featuring in some inflammatory diseases, but the role of NO in chronic viral hepatitis is still unknown. We compared the inducible NO synthase (NOS2) expression in the liver of patients with chronic viral hepatitis with that of both nonviral liver disease and histologically normal liver. NOS2 expression was assessed by immunohistochemical and in situ hybridization studies of liver biopsy sections. An intense hepatocellular NOS2 reactivity was detected in chronic viral hepatitis, whereas it was weakly or not observed in nonviral liver disease or normal liver, respectively. In addition, we determined whether the hepatitis B virus (HBV) might regulate the synthesis of this enzyme. NOS2 mRNA and protein levels as well as enzyme activity were assessed in cytokine-stimulated HBV-transfected and untransfected hepatoma cells. Transfection with either HBV genome or HBV X gene resulted in induction of NOS2 mRNA expression, and the maximal induction of this transcript and NO production was observed in cytokine-stimulated HBV-transfected cells. These results indicate that hepatotropic viral infections are able to upregulate the NOS2 gene expression in human hepatocytes...

‣ Update on chronic viral hepatitis

Walsh, K; Alexander, G
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /08/2001 Português
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Many recent and significant advances in the field of chronic viral hepatitis, including therapy, suggest that an update on chronic hepatitis is timely.
Chronic hepatitis B virus infection remains a significant worldwide cause of liver cirrhosis and hepatocellular carcinoma, despite the wide availability of a long established and effective vaccine. Transmission occurs via perinatal, sexual, and parenteral routes (particularly intravenous drug abuse and although blood products still carry a risk, this is now extremely low in Western countries). Only a minority of infected adult cases develop chronic hepatitis but in children under 1 year, 90% develop chronic hepatitis. The clinical spectrum of chronic liver injury ranges from mild inflammation to end stage liver cirrhosis. Interferon alfa has been the mainstay of treatment for patients with active disease but nucleoside analogues (lamivudine and adefovir) are now available with similar efficacy. Patients with end stage liver disease and hepatocellular carcinoma can be offered transplantation but infection in the graft is commonplace. The combination of hepatitis B immunoglobulin and newer antiviral drugs reduce the incidence and severity of graft infection significantly.
The hepatitis C virus epidemic of the latter half of the 20th century now affects more than 1% of populations worldwide. This RNA virus is spread parenterally and is becoming the leading indication for liver transplantation. The majority of patients develop chronic hepatitis...

‣ The management of chronic viral hepatitis: A Canadian consensus conference 2004

Sherman, Morris; Bain, Vincent; Villeneuve, Jean-Pierre; Myers, Robert P; Cooper, Curtis; Martin, Steven; Lowe, Catherine
Fonte: Pulsus Group Inc Publicador: Pulsus Group Inc
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
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Several government and nongovernment organizations held a consensus conference on the management of acute and chronic viral hepatitis to update previous management recommendations. The conference became necessary because of the introduction of new forms of therapy for both hepatitis B and hepatitis C. The conference issued recommendations on the investigation and management of chronic hepatitis B, including the use of lamivudine, adefovir and interferon. The treatment of hepatitis B in several special situations was also discussed. There were also recommendations on the investigation and treatment of chronic hepatitis C and hepatitis C-HIV coinfection. In addition, the document makes some recommendations about the provision of services by provincial governments to facilitate the delivery of care to patients with hepatitis virus infection. The present document is meant to be used by practitioners and other health care providers, including public health staff and others not directly involved in patient care.

‣ Apoptosis in chronic viral hepatitis parallels histological activity: An immunohistochemical investigation using anti-activated caspase-3 and M30 Cytodeath antibody

McPartland, Jo L; Guzail, Muna Ali; Kendall, Charles H; Pringle, James Howard
Fonte: Blackwell Science Inc Publicador: Blackwell Science Inc
Tipo: Artigo de Revista Científica
Publicado em /02/2005 Português
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Apoptosis is implicated as a major pathogenic mechanism in chronic hepatitis B and C. Previous studies of the relationship between apoptotic rates and histological necroinflammatory activity have produced conflicting results. Hepatocyte apoptosis was assessed in liver tissue from 32 cases of chronic viral hepatitis, seven cases of hepatocellular carcinoma (HCC) and six cases of steatohepatitis as non-viral disease controls and eight cases of control liver. Apoptotic rates were measured using H&E morphological assessment and immunohistochemical staining with antibodies to activated caspase-3 and M30. Histological necroinflammatory activity of viral hepatitis cases was scored using the Knodell scoring system, and the cases were divided according to their score into group 1 (mean 2.43 ± 0.48) and group 2 (mean 7.80 ± 0.49). Apoptotic indices were significantly higher in group 2 than group 1 using H&E (11.53 ± 2.70 vs. 0 ± 0, P = 0.015) and activated caspase-3 (22.01 ± 5.27 vs. 1.79 ± 1.79, P = 0.03) methods but were not significantly higher with M30 (3.80 ± 1.74 vs. 0 ± 0, P = 0.207). Apoptotic scores using an antibody to activated caspase-3 are significantly higher in cases of chronic viral hepatitis with greater histological necroinflammatory scores...

‣ Natural history of chronic viral hepatitis in southern Italy: epidemiological changes since the introduction of the anti-HCV test.

Parrilli, G.; Orsini, L.; Stranges, S.; Cimino, L.; Abazia, C.; Scalice, E.; Manguso, F.; Farinaro, E.; Budillon, G.
Fonte: Cambridge University Press Publicador: Cambridge University Press
Tipo: Artigo de Revista Científica
Publicado em /12/2003 Português
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We investigated whether there are differences between the natural history of B and C chronic hepatitis in a southern Italian population, and whether the chronic viral hepatitis population was modified by the introduction of the anti-HCV test in 1989. We examined clinical charts of 1120 patients consecutively admitted to our division from January 1979 to December 1998 with the histological diagnosis of chronic viral hepatitis (304 from 1979 to 1988; 816 from 1989 to 1998). We found significant differences only in age at diagnosis (higher in the second decade, P = 0.001), and in aetiology (HBV decreased in the second decade, P < 0.0001). We were able to follow up 449 patients for 2-20 years (311 with HCV and 138 with HBV infection), and found that chronic HCV evolved to cirrhosis more frequently than did chronic HBV; but in both types time to development of cirrhosis and the incidence of death were similar. Our data confirm that a higher onset age of HBV and of HCV is frequently observed in those subjects who have a faster disease progression.

‣ Performance of the AST to Platelet Ratio Index (APRI) as a Noninvasive Marker of Fibrosis in Pediatric Patients with Chronic Viral Hepatitis

McGoogan, Katherine E.; Smith, P. Brian; Choi, Steve S.; Berman, Wallace; Jhaveri, Ravi
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/2010 Português
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We investigated the performance of AST to platelet ratio index (APRI) as a non-invasive marker of fibrosis and cirrhosis in children with chronic viral hepatitis. All patients 0–20 years old with chronic hepatitis B or C seen at a tertiary medical center from 1992–2008 were identified. 36 patients were evaluated with 48 biopsy results. The areas under the ROC curve were 0.71 for fibrosis and 0.52 for cirrhosis. When examining subgroups, the APRI performed better in older patients and in those with vertically transmitted HCV. Further research into APRI and other non-invasive markers of fibrosis in children with chronic viral hepatitis is warranted.

‣ Correlation of Kupffer cell function and hepatocyte function in chronic viral hepatitis evaluated with superparamagnetic iron oxide-enhanced magnetic resonance imaging and scintigraphy using technetium-99m-labelled galactosyl human serum albumin

TONAN, TATSUYUKI; FUJIMOTO, KIMINORI; QAYYUM, ALIYA; AZUMA, SANAE; ISHIBASHI, MASATOSHI; UENO, TAKATO; ONO, NORIYUKI; AKIYOSHI, JUNJI; MATSUSHITA, SUNAO; HAYABUCHI, NAOFUMI; KAWAGUCHI, TAKUMI; SATA, MICHIO
Fonte: D.A. Spandidos Publicador: D.A. Spandidos
Tipo: Artigo de Revista Científica
Português
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Kupffer cells contribute to the pathogenesis of liver injury in chronic liver disease, yet it is difficult to assess Kupffer cell function either ex vivo or in vivo, since supporting data are limited. The aim of this study was to clarify the relation between Kupffer cell function and hepatocyte function by analyzing the correlation between conventional indices of hepatic functional reserve and both superparamagnetic iron oxide-enhanced MRI (SPIO-MRI) and technetium-99m-galactosyl human serum albumin scintigraphy (Tc-99m-GSA) in patients with chronic viral hepatitis. Consecutive 46 patients (16 patients with chronic hepatitis and 30 patients with cirrhosis) who underwent both SPIO-MRI and Tc-99m-GSA were examined. The patients were aged 46–83 years (median 70) and included 29 men and 17 women. Spearman correlation coefficient was used to analyze the correlations between functional reserve indices and both reduction percentages of liver-to-muscle signal intensity ratio (reduction-%LMR), as a surrogate parameter of Kupffer cell function and Tc-99m-GSA parameters. The usefulness of each parameter as a marker to differentiate Child-Pugh A from Child-Pugh B/C was evaluated using receiver operating characteristic (ROC) analysis. The reduction-%LMR correlated more closely with Child-Pugh score (r=0.77; P<0.001) than did Tc-99m-GSA parameters. For predicting Child-Pugh B/C...

‣ Natural killer cell functional dichotomy: a feature of chronic viral hepatitis?

Mondelli, Mario U.; Oliviero, Barbara; Mele, Dalila; Mantovani, Stefania; Gazzabin, Chiara; Varchetta, Stefania
Fonte: Frontiers Media S.A. Publicador: Frontiers Media S.A.
Tipo: Artigo de Revista Científica
Publicado em 26/11/2012 Português
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Natural killer (NK) cells are involved in innate immune responses to viral infections either via direct cytotoxicity which destroys virus-infected cells or production of immunoregulatory cytokines which modulate adaptive immunity and directly inhibit virus replication. These functions are mediated by different NK subpopulations, with cytotoxicity being generally performed by CD56dim NK cells, whereas CD56bright NK cells are mainly involved in cytokine secretion. NK functional defects are usually combined so that impaired degranulation is often associated with deficient cytokine production. Innate immunity is thought to be relevant in the control of hepatitis virus infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), and recent findings reproducibly indicate that NK cells in chronic viral hepatitis are characterized by a functional dichotomy, featuring a conserved or enhanced cytotoxicity and a reduced production of interferon (IFN)-γ and tumor necrosis factor-α. In chronic HCV infection this appears to be caused by altered IFN-α signaling resulting from increased signal transducer and activator of transcription 1 (STAT1) phosphorylation, which polarizes NK cells toward cytotoxicity, and a concomitantly reduced IFN-α induced STAT4 phosphorylation yielding reduced IFN-γ mRNA levels. These previously unappreciated findings are compatible on the one hand with the inability to clear HCV and HBV from the liver and on the other they may contribute to understand why these patients are often resistant to IFN-α-based therapies.

‣ Pancreatic involvement in chronic viral hepatitis

Katakura, Yoshiki; Yotsuyanagi, Hiroshi; Hashizume, Kiyoe; Okuse, Chiaki; Okuse, Noriaki; Nishikawa, Kohji; Suzuki, Michihiro; Iino, Shiro; Itoh, Fumio
Fonte: Baishideng Publishing Group Inc Publicador: Baishideng Publishing Group Inc
Tipo: Artigo de Revista Científica
Português
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AIM: To elucidate the frequency and characteristics of pancreatic disorders in the course of chronic viral hepatitis.

‣ The Expression of TLR-9, CD86, and CD95 Phenotypes in Circulating B Cells of Patients with Chronic Viral Hepatitis B or C before and after Antiviral Therapy

Zhao, Ping-wei; Ma, Liang; Ji, Hui-fan; Yu, Lei; Feng, Jun-yan; Wang, Juan; Liu, Ming-yuan; Jiang, Yan-fang
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
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Aims. This study aimed to assess the differential expression of specific B cell subtypes in patients with chronic viral hepatitis. Methods. The frequencies of differential expression of specific B cell subtypes in patients with chronic viral hepatitis and healthy controls were assessed by flow cytometry using monoclonal antibodies specific for CD38, CD27, CD86, CD95, TLR-9, and IgD. The effect of adefovir treatment on B cell subsets in HBV patients was determined. The values of clinical parameters in the patients were also measured. Results. The frequency of CD86+ B cells was not significantly different in chronic HBV patients but was higher in HCV patients compared with that in healthy controls. CD95 and IgD levels were lower in HBV and HCV patients than in healthy controls. A significant negative correlation occurred between the proportion of CD95+ B cells and HBV DNA viral load. The frequency of TLR-9 on the B cells in HBV and HCV patients was higher compared with that of healthy controls. After treatment with adefovir, the frequency of CD95 and IgD expressed on B cells was increased in HBV patients. Conclusions. Activated B cells and exhausted B cells homeostasis were commonly disturbed in HBV and HCV patients.

‣ Capsule oxymatrine in treatment of hepatic fibrosis due to chronic viral hepatitis: A randomized, double blind, placebo-controlled, multicenter clinical study

Mao, Yi-Min; Zeng, Min-De; Lu, Lun-Gen; Wan, Mo-Bin; Li, Cheng-Zhong; Chen, Cheng-Wei; Fu, Qing-Chuen; Wang, Ji-Yao; She, Wei-Min; Cai, Xiong; Ye, Jun; Zhou, Xia-Qiu; Wang, Hui; Wu, Shan-Ming; Tang, Mei-Fang; Zhu, Jin-Shui; Chen, Wei-Xiong; Zhang, Hui-Qua
Fonte: Baishideng Publishing Group Inc Publicador: Baishideng Publishing Group Inc
Tipo: Artigo de Revista Científica
Português
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AIM: To evaluate the efficacy and safety of oxymatrine capsule in treatment of hepatic fibrosis in patients with chronic viral hepatitis.

‣ Is liver biopsy still needed in children with chronic viral hepatitis?

Pokorska-Śpiewak, Maria; Kowalik-Mikołajewska, Barbara; Aniszewska, Małgorzata; Pluta, Magdalena; Marczyńska, Magdalena
Fonte: Baishideng Publishing Group Inc Publicador: Baishideng Publishing Group Inc
Tipo: Artigo de Revista Científica
Português
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Liver biopsy is a standard method used for obtaining liver tissue for histopathological evaluation. Since reliable serological and virological tests are currently available, liver biopsy is no longer needed for the etiological diagnosis of chronic hepatitis B and C. However, liver histology remains the gold standard as a prognostic tool, providing information about the liver disease progression (grading of necroinflammatory activity and staging of fibrosis) and serving clinicians in the management and therapeutic decisions. In general, histopathological evaluation is indicated before starting the antiviral treatment. Main limitations of the liver biopsy include its invasive and painful procedure, sampling errors and the inter- and intra-observer variability. In addition, indications for the liver biopsy in pediatric patients with chronic viral hepatitis were questioned recently, and efforts have been made toward the development of non-invasive methods as an alternative to the liver biopsy. The most commonly used methods are novel imaging studies (elastography) and combinations of biomarkers. However, to date, none of these tests was validated in children with chronic viral hepatitis. In this review, we present the current status of the liver biopsy in the management of chronic viral hepatitis B and C in pediatric population...

‣ Expression of the Serine/Threonine Kinase hSGK1 in Chronic Viral Hepatitis

Fillon, S; Klingel, Karen; Warntges, Simone; Sauter, Martina; Gabrysch, S; Pestel, Sabine; Tanneur, Valerie; Waldegger, S; Zipfel, Annette; Viebahn, R; Haussinger, D; Broer, Stefan; Kandolf, Reinhart; Lang, Florian
Fonte: S Karger AG Publicador: S Karger AG
Tipo: Artigo de Revista Científica
Português
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The human serine/threonine kinase hSGK1 is expressed ubiquitously with highest transcript levels in pancreas and liver. This study has been performed to determine the hSGK1 distribution in normal liver and its putative role in fibrosing liver disease. HSGK1-localization was determined by in situ hybridization, regulation of hSGK1-transcription by Northern blotting, fibronectin synthesis and hSGK1 phosphorylation by Western blotting. In normal liver hSGK1 was mainly transcribed by Kupffer cells. In liver tissue from patients with chronic viral hepatitis, hSGK1 transcript levels were excessively high in numerous activated Kupffer cells and inflammatory cells localized within fibrous septum formations. HSGK1 transcripts were also detected in activated hepatic stellate cells. Accordingly, Western blotting revealed that tissue from fibrotic liver expresses excessive hSGK1 protein as compared to normal liver. TGF-β1 (2 ng/ml) increases hSGK1 transcription in both human U937 macrophages and HepG2 hepatoma cells. H2O2 (0.3 mM) activated hSGK1 and increased fibronectin formation in HepG2 cells overexpressing hSGK1 but not in HepG2 cells expressing the inactive mutant hSGK1K127R. In conclusion hSGK1 is upregulated by TGF-β1 during hepatitis and may contribute to enhanced matrix formation during fibrosing liver disease.

‣ Estudo dos auto-anticorpos nas Hepatites virais crônicas B e C antes, durante e após tratamento com Interferon-alfa; Autoantibodies before, during and after administration of recombinant interferon-alpha for chronic viral hepatitis

Lopes, Edmundo P.A.; Silva, A. Eduardo; Sette Junior, Hoel; Guimarães, Rubens X.; Ferraz, M. Lucia
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/10/1995 Português
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Este estudo teve como objetivo avaliar a presença de auto-anticorpos em pacientes com hepatite crônica pelos vírus B e C, antes, durante e após tratamento com interferon-alfa (IFN-alfa), assim como estudar a relação destes anticorpos com o tipo de IFN, com a dose e com a resposta terapêutica. Cinqüenta pacientes com hepatite viral crônica foram divididos em 2 grupos: grupo-controle constituído por 21 pacientes (10 hepatites B e 11 hepatites C), que foram seguidos durante 6 meses sem tratamento e grupo-IFN constituído por 29 pacientes (8 hepatites B e 21 hepatites C), que receberam IFN-alfa durante 6 meses. Anticorpos antinúcleo, antimúsculo liso, antimitocôndria, anticélula parietal e antitireóide foram pesquisados em amostras de soro colhidas antes do início, durante e ao final do estudo. Quatro dos 50 pacientes (8%) apresentavam auto-anticorpos no início do estudo (2 em cada grupo). Durante o estudo nenhum paciente do grupo-controle desenvolveu auto-anticorpos, enquanto que 3 (11%) pacientes do grupo-IFN passaram a apresentá-los. Os auto-anticorpos ocorreram apenas em pacientes tratados com doses mais elevadas de IFN. Verificou-se ainda tendência à resposta desfavorável ao tratamento naqueles indivíduos que apresentaram ou desenvolveram auto-anticorpos. Assim...

‣ A influência do genoma humano no curso das hepatites virais crônicas; The influence of the human genome on chronic viral hepatitis outcome

Andrade Júnior, Dahir Ramos de; Andrade, Dahir Ramos de
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/06/2004 Português
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Os mecanismos que determinam o clearance ou a persistência da infecção viral nas hepatites virais crônicas não estão ainda bem identificados. O progresso no conhecimento sobre as ferramentas genéticas moleculares tem permitido detectar variações na resposta imune, que freqüentemente são associadas com polimorfismos do genoma humano. As diferenças na susceptibilidade do hospedeiro para as doenças infecciosas e a intensidade das doenças não podem ser atribuídas apenas à virulência do agente microbiano. Neste artigo são discutidos vários avanços recentes no conhecimento sobre a influência dos genes humanos nas hepatites crônicas B e C, a saber: a) As associações entre os polimorfismos HLA e a susceptibilidade ou resistência às doenças hepáticas virais; b) Alelos protetores influenciando as hepatites virais B (HVB) e C (HVC); c) Alelos prejudiciais influenciando HVB e HVC; d) Genes candidatos associados com a evolução clínica de HVB e HVC (genes que influenciam as células estreladas do fígado, a produção de TGF-beta1 e TNF-alfa, os depósitos de ferro hepáticos, a produção de angiotensina II, entre outros). O conhecimento das associações genéticas com as hepatites virais crônicas pode fornecer indícios para o pleno entendimento de como se desenvolvem as suas complicações terminais...

‣ Five-year follow-up of patients with chronic C hepatitis and sustained virological response

Puig-del-Castillo,I.; Miquel-Planas,M.; Vergara-Gómez,M.; Cebollero-Agustí,A.; Gallach-Montero,M.; Dalmau-Obrador,B.; Gil-Prades,M.; Casas-Rodrigo,M.; Sánchez-Delgado,J.; Tomás-Tutusaus,R.; Gavarró-Puig,A.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/02/2011 Português
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Objective: to assess persistence of sustained viral response at 5 years of follow-up in patients with chronic viral hepatitis C treated with pegylated interferon and ribavirin. Design: a descriptive study. Patients: from August 2001 to May 2004, all patients treated at our center with pegylated interferon and ribavirin who achieved a sustained viral response were consecutively enrolled (93 patients). Demographic, histological, biochemical, and virological data were collected during treatment and 5 years after achievement of the sustained viral response. Eighty-six percent of patients enrolled (n = 80) attended the control visit at 5 years. Results: mean age of enrolled patients was 41 years (standard deviation = 10 years), and 30.1% (n = 28) were women. Liver biopsy had been performed before treatment in 68.8% of patients (n = 64), showing no or mild fibrosis in 62.3% (F0 and F1) and significant fibrosis and cirrhosis in 37.7% (F ≥ 3). Genotype distribution was: 58.1% genotype 1 (n = 54); 8.6% genotype 2 (n = 8); 24.7% genotype 3 (n = 23); 7.5% genotype 4 (n = 7), and indeterminate in one patient. Only one patient experienced virological recurrence. All other patients had negative HCV RNA levels and, in the absence of other liver diseases...