Search PubMed⌕ Search

Biomedical subjects

A M Di Bisceglie

Publications and source records attributed to A M Di Bisceglie.

At least 19 recordsLinked to original sources
PubMed2004

Molecular biology and clinical implication of hepatitis C virus.

Hepatitis C virus (HCV) was first described in 1989 as the putative viral agent of non-A non-B hepatitis. It is a member of the Flaviviridae family and has been recognized as the major causative agent of chronic liver disease, including chronic active hepatitis, cirrhosis and hepatocellular carcinoma. HCV is a positive RNA virus with a genome containing approximately 9500 nucleotides. It has an open reading frame that encodes a large polyprotein of about 3000 amino acids and is characterized by extensive genetic diversity. HCV has been classified into at least 6 major genotypes with many subtypes and circulates within an infected individual as a number of closely related but distinct variants known as quasispecies. This article reviews aspects of the molecular biology of HCV and their clinical implication.

3' Untranslated Regions↗
PubMed2004

Long term follow up of bone mineral density in patients with primary biliary cirrhosis.

AIM: Osteodystrophy is a well known complication of cholestatic liver diseases such as primary biliary cirrhosis (PBC), although the factors predisposing to the development of metabolic bone disease and its natural history have not been well studied. METHODS: We followed a cohort of patients, predominantly post-menopausal females, for changes in bone mineral density over a period of up to 8 years. RESULTS: We found that most patients with PBC have relatively stable lumbar bone density over time, even in the face of progressive liver disease. Only 2 of 22 patients experienced fractures. Both of these patients had low initial bone density measurements. CONCLUSIONS: We recommend that all patients with newly diagnosed PBC undergo bone mineral density measurement so as to identify those at greatest risk of pathological fractures.

Adult↗
PubMed2003

Molecular and serological aspects of HBsAg-negative hepatitis B virus infections in North America.

A few hepatitis B virus (HBV) infections are characterized by the presence of HBV DNA in serum or liver tissue, or both, in the absence of detectable hepatitis B surface antigen (HBsAg) in serum. However, such infections have rarely been described previously in North American patients. In the present study, 31 hepatocellular carcinoma (HCC) patients from the United States and Canada who had no detectable HBsAg in their serum were studied. In these 31 HBsAg-negative HCC patients, HBV DNA was detected in HCC and/or in adjacent nontumorous liver tissue using nested polymerase chain reaction (PCR) in 5/9 (56%) patients from the United States and in 12/22 (55%) from Canada. The 17 HBV DNA-positive/HBsAg-negative patients from the United States and Canada included 9 without any serological markers for HBV and 8 with detectable antibodies to hepatitis B core antigen. In these patients, HBV genotype C was the most prevalent genotype (11/17; 64%). HBV genotypes have not been previously reported in HCC patients from North America. Replicative intermediate forms of HBV (covalently closed circular HBV DNA) were detected in 2/17 (12%) HBV DNA-positive/HBsAg-negative patients, indicating that at least two of these patients had actively replicating HBV infections. The use of tests to detect HBV DNA permitted the identification of HBV infections in HBsAg-negative HCC patients from North America. Among these patients, those with antibody to hepatitis C virus (HCV) would otherwise have been designated "HCV-associated HCCs" based on serological tests alone. These findings provide a new perspective on determining the possible viral etiologies of HCCs in North America.

Amino Acid Sequence↗
PubMed2002

Combination therapy for hepatitis B.

Hepatitis B virus is a major cause of morbidity and mortality worldwide. Effective therapies were first introduced in the mid-1980s but frequent and sometimes severe side effects limit their use. Combination therapy represents the future of treatment for chronic hepatitis B, probably consisting of two or more nucleoside analogues although interferon may form part of some combinations. New drugs acting by different antiviral mechanisms may be particularly potent in combination.

2-Aminopurine↗
PubMed2001

Differential amplification of hypervariable region 1 of hepatitis C virus by partially mismatched primers.

The quasispecies nature of hepatitis C virus (HCV) has been well documented over its whole genome and the most variable domain is located at the 5' end of the second envelope region, the so-called hypervariable region 1 (HVR1). HVR1 has therefore been extensively used as the target for characterizing HCV quasispecies profiles. In this study, we reported our finding that partially mismatched primers preferentially amplify different HVR1 sequences in a heterogeneous virus population. This finding suggests a possible mechanism of bias during the amplification of HVR1 sequences and may be responsible for some conflicting data regarding evolutionary or clinical implications of HCV quasispecies.

Amino Acid Sequence↗
PubMed2001

Genetic characterization of hypervariable region 1 in patients chronically infected with hepatitis C virus genotype 2.

The hypervariable region 1 (HVR1) has been most reliably identified in the genome of HCV genotype 1 isolates and thought to possibly play a role in immune evasion and development of chronic infection. There are few studies, however, of other HCV genotypes to determine if they also have such a hypervariable region present, and it is unclear whether or not there is any genotype-dependent difference in the genetic characteristics of HVR1. We determined the nucleotide sequence of 5' end of E2/NS1 region of the HCV genome spanning HVR1 of multiple genotype 1 and 2 HCV isolates and carried out a detailed genetic analysis. Similarity plots identified two hypervariable regions within the genotype 2 sequences, a larger one corresponding to HVR1 as well as a smaller 27-nucleotide region of hypervariability. The synonymous substitutions per synonymous site (ds) was greater than nonsynonymous substitutions per nonsynonymous site (dn) within genotype 1 group whereas dn and ds were similar in the genotype 2 group. Analysis of amino acid sequences revealed several conserved sites across genotype 1 and 2 (amino acid numbers 2,6, 20 and 26) and overall similar hydropathic profiles were found within two genotypes. Still, despite the hypervariability, the HVR1 showed a genotype-specific phylogenetic clustering. Thus, HVR1 appears to be conserved between genotypes in keeping with it having an important survival function. Genotype 2 appears to have a greater rate of nonsynonymous substitutions within HVR1, suggesting a greater positive evolutionary pressure.

Amino Acid Sequence↗
PubMed2001

Cryoglobulinemia associated with Purtscher-like retinopathy.

PURPOSE: To report a case of Purtscher-like retinopathy in a young man with chronic hepatitis C--associated cryoglobulinemia. METHODS: Case report. RESULTS: A 44-year-old Caucasian man with chronic hepatitis C developed sudden loss of vision in the left eye and abdominal pain. Ocular fundus examination revealed peripapillary cotton-wool spots and superficial retinal whitening in the macula. Systemic evaluation revealed markedly elevated rheumatoid factor, hypertension, and acute renal insufficiency. A renal biopsy demonstrated intravascular deposition of immunoglobulins IgG and IgM and complement consistent with type II mixed cryoglobulinemia. CONCLUSION: Clinicians should consider cryoglobulinemia in the differential diagnosis of a patient with Purtscher-like retinopathy and history of infection with hepatitis C.

Adult↗
PubMed2001

Expression of c-myc promoter binding protein (MBP-1), a novel eukaryotic repressor gene, in cirrhosis and human hepatocellular carcinoma.

We have examined the expression of c-myc and c-myc promoter binding protein (MBP-1), a novel eukaryotic repressor, in human hepatocellular carcinoma and cirrhosis by semiquantitative reverse transcription PCR amplification. Levels were normalized for glyceraldehyde-3-phosphate dehydrogenase messenger RNA and then compared between these two groups and to normal liver. We found that MBP-1 expression was significantly decreased in cirrhosis and c-myc and MBP-1 were even further diminished in hepatocellular carcinoma. There was no clear correlation between MBP-1 and c-myc messenger RNA levels. Our results therefore suggest that expression of MBP-1 and c-myc are decreased in a stepwise fashion in the presence of chronic liver disease and hepatocellular carcinoma in humans and that further study of the interactions of these two genes and their products is warranted to determine their role in human hepatocarcinogenesis.

Biomarkers, Tumor↗
PubMed2001

Increased hepatic oxidative DNA damage in patients with hepatocellular carcinoma.

Since oxidative DNA damage plays a role in experimental carcinogen-induced cancers, the purpose of the present study was to determine if hepatic oxidative DNA damage was increased in patients with HCC compared to patients with benign hepatic tumors or hepatic metastases (non-HCC) or to patients with end-stage alcoholic liver disease undergoing liver transplantation. Oxidative DNA damage was assessed by 8-hydroxy-2'-deoxyguanosine (8-OH-dG). Results showed that peritumoral 8-OH-dG was markedly increased in HCC (N= 51) (180 +/- 74 vs 32 +/- 58-OH-dG/10(6)dG for tumor, P < 0.005) in contrast to patients with non-HCC (N = 17), in whom the peritumoral 8-OH-dG did not differ from that in tumor (39 +/- 7 vs. 31 +/- 108-OH-dG/10(6)dG). Oxidative DNA damage can be both mutagenic and carcinogenic; our data suggested it will be important in future studies to determine the chronology of this type of liver injury relative to hepatocarcinogenesis.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2001

Combination of interferon and ribavirin in chronic hepatitis C: re-treatment of nonresponders to interferon.

Chronic infection with hepatitis C virus (HCV) may result in cirrhosis, liver failure, and hepatocellular carcinoma. A minority of patients have a sustained response to antiviral therapy, and nonresponders remain at risk of developing progressive liver disease. We conducted a randomized, controlled trial of therapy with the combination of interferon (IFN) and ribavirin in patients with chronic hepatitis C who had not responded to an initial course of therapy with IFN alone. A total of 124 patients were randomized to receive the combination of IFN and ribavirin for either 24 or 48 weeks and followed for an additional 24 weeks after stopping therapy. Thirty-eight treated patients (30.6%) achieved a sustained virologic response (undetectable HCV RNA at the 24-week follow-up point). This was associated with significant improvement in necroinflammatory activity noted on liver biopsy. Interestingly, there was not a statistically significant difference in response rates based on the duration of treatment; HCV genotype was the strongest predictor of a sustained response. Sustained responses were noted even in patients with poor predictive factors, including those with advanced hepatic fibrosis or cirrhosis, high levels of HCV RNA in serum, and those infected with HCV genotype 1. The study included 24 patients with normal serum alanine transaminase (ALT) values before therapy who had similar responses to those with initially elevated transaminase values. This study suggests that the combination of IFN and ribavirin is a useful modality of therapy in patients with chronic hepatitis C who did not respond to IFN alone.

Adult↗
PubMed2001

Changes in serum lipoprotein profile during interferon therapy in chronic hepatitis C.

OBJECTIVES: Therapy with a interferon is associated with a rise in serum triglyceride levels, although this effect has not been well studied with newer forms of interferon or interferon in combination with ribavirin. METHODS: Review of combined data obtained from several prospective, randomized controlled clinical trials conducted in the clinical studies unit of a tertiary care referral center among patients with chronic hepatitis C undergoing treatment with various forms of a interferon, with or without the addition of ribavirin. Serum levels of triglycerides and cholesterol were measured before and during therapy. Changes in these levels were correlated with baseline characteristics. RESULTS: At baseline, the mean serum triglyceride level among 152 patients studied was 130 mg/dL (range 32-620) and was elevated above normal in three patients (2%). During therapy, triglyceride levels rose significantly early on and began to decline spontaneously after 12 wk, returning to baseline after stopping treatment. Triglyceride levels rose above 500 mg/dL in 18 patients (12%) and above 1000 mg/dL in two patients (1.3%) although none experienced acute complications or clinical symptoms. Serum cholesterol levels did not change significantly during therapy (mean at baseline 172 vs 168 mg/dL at 24 wk). Factors correlated with the rise in triglycerides included baseline triglyceride levels, HCV genotype, and the type of interferon used. CONCLUSIONS: Serum triglyceride levels increase consistently in patients with chronic hepatitis C treated with all forms of a interferon, often to very high levels. These changes do not seem to be associated with clinical signs or complications and triglyceride levels decline while patients are still on therapy and return to normal after stopping.

Adult↗
PubMed2001

What is the optimal therapy for chronic hepatitis B?

Chronic infection with the hepatitis B virus infection remains a major problem worldwide despite some decrease in its incidence after improvement in public health policies and the utilization of hepatitis B vaccine. The clinical spectrum of the disease ranges from the asymptomatic carrier and individuals with mild liver injury to cirrhosis and hepatocellular carcinoma. During the past two decades there has been important progress in the field of viral hepatitis, and several drugs for the treatment of chronic hepatitis B have been developed and analyzed in clinical trials. Currently, two forms of therapy have been approved and are available for clinical practice: alpha interferon and lamivudine. Neither therapy is entirely satisfactory because of side effects and lack of universal responses. There is also controversy over which patients should be treated and what agent and regimen should be used. In this review we discuss the advantages and disadvantages of utilizing either drug, the response rates to therapy and what regimen should be used.

Antiviral Agents↗
PubMed2000

A comparison between the phenol-chloroform method of RNA extraction and the QIAamp viral RNA kit in the extraction of hepatitis C and GB virus-C/hepatitis G viral RNA from serum.

Viral RNAs are detected commonly in serum by hybridization and polymerase chain reaction (PCR) methods for both clinical and research purposes. Two methods of extracting viral RNA were evaluated prior to amplification by PCR. One was a conventional phenol-chloroform method and the other used a standardized, manufactured kit. The efficiency of extraction was tested by semi-quantitative amplification of hepatitis C viral and GB virus-C/hepatitis G viral RNAs. The standarized commercial method, although more time efficient, resulted in an approximately ten fold less sensitivity. Thus, in situations where maximum sensitivity is needed, the more labor intenstive phenol choloroform method is recommended.

Chloroform↗