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Biomedical subjects

M R Brunetto

Publications and source records attributed to M R Brunetto.

113 records · Page 7Linked to original sources
PubMedDate not supplied

The impact of molecular biology in the diagnosis and management of viral hepatitis.

In recent years molecular biology techniques allowed an extraordinary progress in knowledge of hepatitis viruses. New informations have accumulated on the mechanisms of virus replication and on the pathogenesis of liver damage. In the clinical setting, simple noninvasive methods that use the same technological approach provide a useful diagnostic tool for infections of hepatitis B virus (HBV) and hepatitis delta virus (HDV). Using these tests we may define whether a carrier of hepatitis B surface antigen has a liver damage due to HBV or HDV or to other, non-virological causes. Detection of HBV-DNA and HDV-RNA in serum and liver can also be used as a guide for prognosis and therapy.

Animals↗
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Patterns of natural killer cell function activation in response to interferon in chronic HBsAG positive hepatitis: relationship with the state of viral infection and with the early clinical response.

In an effort to define immunobiological parameters identifying "responders" vs "non-responders" to IFN among hepatitis patients, 16 patients with chronic active hepatitis were screened for changes of Natural Killer cell activity (NK). 10/16 patients replicated the hepatitis B virus (HBV-DNA positive) whereas 6/16 replicated the defective B virus associated delta virus (HDV-RNA positive). Patients received 9 MU/3x/weekly/3 months of recombinant IFN alpha A. Mean NK activity of the HBV-DNA patients rose significantly from 29.9 +/- 5.3 to 45 +/- 4.7 during therapy, whereas the 6/16 HDV-RNA positive patients did not show any significant increase of NK activity. Interestingly, individual HDV-RNA positive patients exhibiting boosted NK activity also showed improvement of disease confirmed by clearance of intrahepatic delta antigen at one year. No such a correlation was found amongst the HBV-DNA positive patients. These data indicate that in spite of widespread individual variability, IFN-mediated NK boost may herald delta clearance and help in identifying "responders" and "non-responders" in IFN trials.

Adult↗
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Alpha-fetoprotein in hepatic pathology and hepatocarcinoma.

We have examined a population of 1099 patients, suffering of HCC and chronic hepatitis of different nature, to determine the frequency and significance of alpha-fetoprotein elevation. Moreover we have followed up a group of 206 patients with liver cirrhosis referred to our department of hepatology in Turin, from January 1981 through April 1989. The AFP test with a cut-off of 50 ng/ml, is positive in 67.2% of tumor patients and in 12.9% of chronic hepatitis. No differences exist in patients carriers of hepatitis B virus versus alcoholic or criptogenetic subjects. Twenty-one out of 206 cirrhotic patients followed-up have developed HCC during the observation period (36.5 +/- 22.4 months). Fifteen out 21 patients (71%) showed an increase of AFP values. In 14 patients the HCC was graded as small (less than 4 cm of diameter at US) and in other 7 as advanced or multifocal. The underlying cirrhosis was alcoholic in 11 (53.3%), cryptogenic in 5 (23.8%), and hepatitis B chronic infection related in 5 (23.8%). Serological surveillance has led, to the identification of 71% of the tumors developing during this study. Using the time-course of AFP as the diagnostic parameter of the risk of HCC, we obtained the best performance in term of sensitivity, specificity and diagnostic accuracy. Screening patients at risk of HCC, using abdominal US and AFP testing, is an effective way of determinating small lesions, but how much early determination of HCC in a cirrhotic patient will improve the prognosis remain to be defined.

Aged↗
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Hepatitis C virus infection and liver disease.

Hepatitis C Virus (HCV) is a RNA virus that lacks the retroviral properties of surviving in infected hosts by integration into cellular DNA, nevertheless it is capable to cause chronic infection and disease in a considerable number of infected individuals (30-70% of cases). This results in a worldwide prevalence of chronic HCV carriers similar to those of hepatitis B virus carriers. We review and discuss here some of the peculiar aspects of chronic HCV infection and associated disease.

Hepatitis C↗