Koji Umeshita, Hiroyuki Furukawa, Shinji Uemoto. “
“Background and Aim: Hepatitis E virus (HEV) infection is endemic in several developing countries. Clinical manifestations of this infection vary widely
from asymptomatic infection to uncomplicated acute viral hepatitis and fulminant hepatic failure. The pathogenesis of this disease and the reason of varying disease severity remain unknown. In viral infections, tissue injury can be caused either by virus itself or by host immune responses directed against infected cells. We therefore studied adaptive immune responses to HEV antigens in patients with hepatitis E of varying disease severity and healthy controls. Methods: Cytokine secreting CD4+ T cells and antibody-producing B cells specific for HEV were enumerated through intracellular cytokine selleck chemicals llc staining and enzyme-linked immunosorbent spot assay, respectively. Results: Patients with fulminant hepatitis E had a less marked expansion of HEV-specific interferon-γ or tumor necrosis factor-α secreting CD4+ T cells than patients with uncomplicated hepatitis
Midostaurin E and healthy controls. These patients also had fewer CD4+ T cells that produce γ-interferon or tumor necrosis factor-α upon in vitro polyclonal stimulation. In addition, patients with fulminant disease had a more marked expansion of B cells that can secrete immunoglobulin G anti-HEV than patients with uncomplicated infection and control patients. Conclusion: These findings suggest that less-marked antiviral cellular immune responses and heightened antiviral humoral responses are associated with a more severe disease during HEV infection. “
“Despite proven clinical benefit, there are no studies that have examined the relationship between pancreatic stent caliber and its impact on PEP [post-endoscopic retrograde cholangiopancreatogram (ERCP) pancreatitis] in high-risk patients. To study the relationship between stent caliber and PEP rates in patients with confirmed sphincter of Oddi dysfunction (SOD). A retrospective review was
conducted of ERCP’s in patients with SOD from 2002 to 2012 Y-27632 2HCl from a prospectively maintained, Institutional Review Board approved database. A total of 243/7659 (3.2%) patients underwent 3Fr or 5Fr pancreatic stent placement following sphincterotomy for manometry-proven SOD. Of these, 133 (54.7%) underwent 3Fr stent placement, while 110 (45.3%) underwent 5Fr stent placement. There was no significant difference between the two groups in terms of baseline characteristics, demographics, and previous cholecystectomy. Cannulation and stent placement success rates were 100% in both groups. There was no significant difference in rates of PEP and overall complications, 12% versus 12.7%; P = 0.89 and 13.5% versus 15.5%; P = 0.