Biomedical subjects

E Del Ninno

Publications and source records attributed to E Del Ninno.

At least 37 records · Page 2Linked to original sources

PubMed1991

Hepatitis C antibody in patients with chronic liver disease and hepatocellular carcinoma.

Hepatitis C virus (HCV) is the major etiologic agent of parenterally transmitted non-A, non-B hepatitis. To determine whether there is a relationship between this virus agent and hepatocellular carcinoma (HCC), the sera of patients with HCC and chronic hepatitis were assessed using a sensitive immunoassay for HCV antibody. Anti-HCV was detected in 65% of 132 patients with HCC, without any relationship with the presence of the hepatitis B surface antigen (HBsAg). The prevalence (74%) of anti-HCV was high, as expected in patients with putative non-A, non-B cirrhosis also. The prevalence of anti-HCV was less in patients with HBsAg-positive cirrhosis (28%) and in patients with disease not related to viral hepatitis and healthy controls (8%). These data suggest, but do not prove, that HCV is an important factor associated with HCC.

Carcinoma, Hepatocellular↗

PubMed1989

Prevalence of antibodies to hepatitis C virus in Italian patients with hepatocellular carcinoma.

A sensitive radioimmunoassay was used to detect antibodies to hepatitis C virus (HCV) in patients with hepatocellular carcinoma and chronic hepatitis. HCV antibodies (anti-HCV) were detected in 86 of 132 patients with hepatocellular carcinoma with no relation to the presence or absence of hepatitis B surface antigen (HBsAg). The prevalence of anti-HCV was also high in patients with diseases thought to predispose to hepatocellular carcinoma, such as non-A, non-B chronic hepatitis and cirrhosis (74%). In HBsAg-negative patients with hepatocellular carcinoma the prevalence of anti-HCV was lower than that in patients with non-A, non-B chronic hepatitis (16% vs 55%); the prevalence of serum antibodies to hepatitis B core antigen (anti-HBc), a marker of hepatitis B virus infection, was 70% and 28%, respectively. In HBsAg-negative patients with hepatocellular carcinoma, anti-HCV and anti-HBc occurred together nearly three times as often as in patients with chronic hepatitis (54% vs 19%). These data indicate that, in Italy, HCV is an important factor associated with hepatocellular carcinoma and non-A, non-B chronic hepatitis.

Adult↗

PubMed1988

Ultrasound-assisted percutaneous liver biopsy: superiority of the Tru-Cut over the Menghini needle for diagnosis of cirrhosis.

A total of 1192 consecutive patients with diffuse liver disease were randomized to have percutaneous liver biopsy specimens taken with the Menghini or the Tru-Cut needle, to compare tissue yield, safety, and accuracy of the two needles for diagnosing cirrhosis. The sites of puncture were determined by prebiopsy ultrasound scans. Adequate samples were obtained from 94% with the Tru-Cut needle and from 79.2% with the Menghini needle (p less than 0.001). Accuracy in diagnosing cirrhosis was 89.5% for the Tru-Cut needle and 65.5% for the Menghini needle (p less than 0.05). Complication rates were very low and similar for both needles. Under these conditions, the Tru-Cut needle is superior to the Menghini needle for diagnosing cirrhosis.

Biopsy, Needle↗

PubMed1986

Idiopathic haemochromatosis and HLA antigens in Italy: is A3 Bw35 HLA haplotype a marker for idiopathic haemochromatosis gene in north east regions?

Thirty two unrelated Italian subjects with idiopathic haemochromatosis were studied. HLA-A3 was present in 26 of them (81% v 22% in controls; p less than 0.001) and HLA B7 in eight (28% v 9%; p less than 0.01). There was no important association between idiopathic haemochromatosis and HLA B14. Subdividing the patients on the basis of their regional origin a noticeably higher prevalence of HLA Bw35 in patients with idiopathic haemochromatosis from north eastern Italy was found than in those from Lombardy, or in the controls; there were no differences in the incidence of HLA A3 and B7 between patients with idiopathic haemochromatosis from different areas. A high prevalence of A3, Bw35, and A3, B7 haplotypes was found in our patients with idiopathic haemochromatosis. A3, Bw35 could be the haplotype most commonly linked to the idiopathic haemochromatosis gene in north eastern Italy.

Adult↗

PubMed1986

[Natural history of the state of asymptomatic carrier of HBsAg: 7-year follow-up].

UNLABELLED: Ninety-six chronic asymptomatic HBsAg carriers underwent liver biopsy. Liver histology was normal in 5 cases, showed nonspecific changes in 67, chronic persistent hepatitis in 18, and chronic-active hepatitis in 6. Seventy-four patients were followed for up to 105 months (mean 80 months) in order to evaluate the occurrence of clinical, biochemical, serological or histological changes. Only two patients cleared the HBsAg, respectively 10 and 96 months after undergoing liver biopsy; the latter patient became anti-HBs positive 6 months after he cleared HBsAg. All 10 patients who initially were negative for both HBeAg and anti-HBe became anti-HBe positive during follow-up. All 4 patients who were HBeAg positive at the time of liver biopsy cleared HBeAg 6 to 39 months thereafter. Two of them became anti-HBe positive. None of the patients initially HBeAg negative became positive for this antigen during follow-up. Significant increases of serum transaminases were observed in 5 patients; in one superinfection by delta agent was documented, the other 4 being constantly anti-delta negative. Three of the latter patients underwent repeat liver biopsy, which showed progression from minimal changes to chronic persistent hepatitis in one, and from minimal changes to chronic active hepatitis in another. In the third patient, repeat biopsy showed persistence of chronic persistent hepatitis. IN CONCLUSION: chronic hepatitis occurs in about 25% of chronic asymptomatic HBsAg carriers; clearance of HBsAg is a rare event among these patients; the HBe system has little diagnostic or prognostic value; delta superinfection is rare; however, deterioration of liver histology may occur even in the absence of delta superinfection.

Adolescent↗

PubMed1985

The significance of protein C antigen in acute and chronic liver biliary disease.

Protein C, a naturally occurring inhibitor of blood coagulation, was measured immunologically in 160 patients with acute and chronic liver and biliary disease. In 31 patients with acute viral hepatitis serially studied from admission to discharge from hospital, protein C antigen (PC:Ag) was low on admission in a high proportion of cases (61%) but became normal in 90% of them after two weeks at a time when the prothrombin time was still prolonged in 46% of the cases. PC:Ag was also low in 25 cirrhotic patients and in 20 patients with chronic active hepatitis. In chronic hepatitis and cirrhosis, PC:Ag levels significantly correlated with indexes of liver synthetic function. In primary biliary cirrhosis (n:40), PC:Ag was low in patients with advanced disease (stages III-IV) but high in the early phases, when cholestasis was not yet accompanied by impaired protein synthesis. PC:Ag was also very high in 20 patients with large bile duct obstruction and highly correlated with indexes of cholestasis. The authors' findings indicate that PC:Ag is reduced in liver disease proportionally to the impairment of the liver synthetic function and that its normalization after acute hepatitis might represent an early marker of recovery of this function.

Acute Disease↗

PubMed1985

Hepatocellular carcinoma in Italy: report of a clinical trial with intravenous doxorubicin.

Sixty-six patients with hepatocellular carcinoma (HCC) in various stages of hepatic involvement were studied prospectively. Of these, 50 (75%) had associated cirrhosis and 19 (28%) had serum hepatitis B surface antigen (HBsAg). Six (9%) patients were eligible for tumor resection, 34 were selected for doxorubicin chemotherapy (60 mg/m2, i.v., given every 3 weeks, up to a maximum dose of 550 mg/m2), and 26 were followed up without treatment. Untreated patients survived 1-18 months (median 1) after diagnosis. Surgically treated patients survived 1-14 months (median 4.5). In the doxorubicin group, six patients died soon after the first course of treatment, leaving 28 patients to be evaluated. Seven (24.5%) responded to therapy, surviving 2-26 months (median 8.0). Twenty-one (75.5%) did not respond to chemotherapy and had a median survival of 3.5 months (range: 2-12). Initial performance status and the degree of hepatic impairment were found to be covariates of prognostic significance. The type and severity of drug-related side-effects appeared to be comparable to those reported by others. In accordance with previous reports, our patients with HCC often had non-resectable tumors or responded poorly to chemotherapy. The association between this tumor and cirrhosis might partially account for treatment failure.

Adult↗

PubMed1984

Decrease in suppressor/cytotoxic T-cells with histamine receptors in patients with chronic active hepatitis.

A fluorescence assay was employed to measure the levels of circulating suppressor/cytotoxic T cells with membrane receptors for histamine (H+T cells) in 33 patients with chronic active hepatitis, in seven patients with metabolic and vascular liver disorders and in 25 healthy individuals. The H+T cells were decreased in patients with CAH (4.6 +/- 2.2 cells/mm3 vs 16 +/- 3.9 cells/mm3; p less than 0.001), but were normal in patients with metabolic or vascular liver diseases (17.6 +/- 6 cells/mm3 vs 16 +/- 3.9 cells/mm3; NS). Patients with HBsAg-negative CAH had fewer circulating H+T cells than those with HBsAg-positive CAH (p less than 0.05). The same was true for patients with cirrhosis as compared to those without. The lymphocyte alterations were independent of the nature and course of CAH, but correlated inversely with the serum levels of gammaglobulins and with the histological features of hepatic inflammation (p less than 0.05). Like other sets of lymphocytes, the H+T cells in CAH may have locally either immunomodulatory or cytotoxic effects. In analogy with other immune disorders (histiocytosis X, atopic dermatitis), one might speculate that the alterations in H+T cells in CAH represent derangement of the immunoregulatory cell network. The absence of systemic features of autoimmunity in viral CAH correlates with the demonstration that H + T cells exert their immunoregulatory effects at the sites of inflammation where histamine is being released.

Adolescent↗

PubMed1983

In situ characterization by monoclonal antibodies of the mononuclear cell infiltrate in chronic active hepatitis.

To characterize the inflammatory infiltrate of chronic active hepatitis we have examined 26 liver biopsy specimens [16 hepatitis B surface antigen-negative and 10 hepatitis B surface antigen-positive] with monoclonal antibodies and antiimmunoglobulins that react against the following mononuclear cell populations: T cells, T4 cells, T8 cells, monocytes-macrophages, Ia-positive cells, surface Ig-bearing cells, natural killer/killer cells. A biotin-avidin-fluorescein technique was used and the number of positive cells was counted in a portal tract that was more severely involved. The T cells predominate in all the specimens. The T4:T8 cell ratio and the number of T and T4 cells in the hepatitis B surface antigen-negative patients are higher than in the hepatitis B surface antigen-positive patients. While natural killer/killer cells, surface Ig-bearing cells, and macrophages are always rare, Ia-positive cells are numerous and the double-staining technique demonstrates a fair number of cells displaying both T-cell and Ia markers. These findings, while not supporting a major role of killer cells in chronic active hepatitis, suggest a different alteration of T-cell subsets in hepatitis B surface antigen-positive and -negative chronic active hepatitis.

Adult↗

PubMed1983

Long-term delta superinfection in hepatitis B surface antigen carriers and its relationship to the course of chronic hepatitis.

To assess the prevalence and clinical significance of delta-infection in chronic hepatitis B surface antigen carriers, we examined 326 liver biopsies from 192 retrospectively selected carriers by immunofluorescence. Delta antigen was detected in 102 specimens from 50 carriers (26.2%) with peak prevalence in patients with active cirrhosis (51.5%) and generally in close association with progressive liver disease (94%). The antigen was located in the nuclei of 2%-50% of the hepatocytes, without any disease-specific pattern of fluorescence. Patients with intrahepatic delta-antigen, however, had more severe liver disease than those without it. Histologic follow-up of 101 cases showed that the rates of worsening of the liver disease were similar in delta-antigen-positive and in delta-antigen-negative patients. It is concluded that delta-superinfection does play a role in worsening the histologic picture of hepatitis B surface antigen-positive chronic active hepatitis, possibly by liver injury induced acutely at the moment of infection.

Adolescent↗

PubMed1982

Geographic differences in HBV related, autoimmune, and cryptogenic chronic active hepatitis.

To clarify the importance of ethnic and geographic factors in chronic active hepatitis (CAH), HBV markers and autoantibodies (AMA, ANA, SMA), have been compared in 158 patients with biopsy-proven CAH from New York City and in 92 patients with CAH from Milan. HBsAg-positive CAH was more frequently observed in Milan (49%) than in New York City (27%). However, among HBsAg-positive patients, HBcAg, HBeAg, and epidemiologic risk factors for acquisition of HBV infection were more frequently found in New York than in Italy. The prevalence of HBsAg-negative, anti-HBc-positive CAH and cryptogenic CAH was similar in the two cities, while autoimmune CAH was more frequently observed in New York (20%) than in Milan (2%). In particular, the prevalence of autoimmune hepatitis was higher among Jewish patients than among patients of Anglo-Saxon or Latin ethnic background in New York. Thus, environmental and/or ethnic factors may influence the prevalence of the four major types of CAH.

Antibodies↗

PubMed1980

Chronic asymptomatic HBSAg carriers: histologic abnormalities and diagnostic and prognostic value of serologic markers of the HBV.

Liver histology, the serum "e" antigen system, and DNA-polymerase activity were studied in 68 chronic asymptomatic HBSAg carriers with normal liver chemistries in order to assess the frequency of chronic hepatitis and the diagnostic and prognostic usefulness of serum HBV markers in these subjects. Liver histology was normal in 3 cases, showed nonspecific changes in 46, chronic-persistent hepatitis in 16, and moderate chronic active hepatitis in 3. The "e" antigen and DNA-polymerase activity were positive in 2 and 5 cases, respectively, and were associated with either minimal inflammatory changes or chronic-persistent hepatitis. The "e" antibody was found in 28, evenly distributed among the varios histologic categories; 2 out of 3 patients with chronic active hepatitis carried the "e" antibody. Sixty-four patients have been followed prospectively for 12-30 mo with serial liver tests. During follow-up, 1 patient, with minimal inflammatory changes on liver biopsy and negative for "e" antigen, antibody or DNA-polymerase activity, developed consistently abnormal transaminases, and showed progression to chronic active hepatitis on repeat biopsy. In another patient with chronic-persistent hepatitis, "e" antigen and DNA-polymerase activity reverted to entirely normal serologic status. In our large series, the frequency of chronic hepatitis among HBSAg carriers with normal liver chemistries was somewhat higher than previously reported. In these subjects, the "e" antigen status did not correlate closely with liver histology and did not seem to provide reliable short-term prognostic information.

Adult↗

PubMed1975

Asymptomatic liver disease in haemophiliacs.

The incidence of jaundice and of abnormal liver function tests has been assessed in 91 multitransfused patients with severe haemophilia A and B. Tests of hepatocyte function were within the normal range in the majority of patients. On the contrary, tests of biliary cell function, liver cell damage, and bromsulphthalein retention gave high rates of abnormal values, which tended to increase with age. Hepatitis B surface antigen was present in 8% and the corresponding antibody in 66% of the cases; 18% had a history of jaundice. All patients were asymptomatic and only a minority showed clinical signs of liver involvement. These data suggest that in haemophilacs repeated and prolonged contact with the agent(s) responsible for post-transfusion hepatitis may cause chronic liver damage not associated with overt illness.

Adolescent↗

PubMed1975

[Incidence of HBsAg in persons living with HBsAg carriers].

The prevalence of HBsAg was studied, by Counterelectrophoresis and Radioimmunoassay, in 232 household contacts of 65 HBsAg carriers. The overall incidence of HBsAg in household contacts was 14,65%, as compared with the generally accepted figure of about 1% in the general population in Italy. As far as the prevalence of HBsAg and abnormal liver function tests is concerned, no differences were found between contacts of carriers with Chronic Active Liver Disease and contacts of asymptomatic carriers. The prevalence of HBsAg was similar in spouses (13,5%) and in blood relatives (15,3%) of carriers. It is concluded that: 1) Household contacts of HBsAg carriers are at higher risk of acquiring HBsAg infection than the general population. 2) Such risk is not increased by the presence of Chronic Active Liver Disease in the index cases. 3) Further studies are required in order to clarify the relative roles of environmental and genetic factors as determinants of HBsAg transmission.

Adult↗

PubMed1974