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DUODENAL BUT NOT FAECAL EOSINOPHIL DERIVED NEUROTOXIN IS ASSOCIATED WITH DUODENAL EOSINOPHILS IN FUNCTIONAL DYSPEPSIA

Matthias Ceulemans 1, Pauline Huyghe 1, Ayçe Idil Cetin 1, Apollo van de Geer 1, Inge Jacobs 1, Jonathan Cremer 1, Lucas Wauters 1,2, Jan Tack 1,2, Tim Vanuytsel 1,2

Affiliations

1 KU Leuven, Leuven, Belgium

2 UZ Leuven, Leuven, Belgium

Summary

AI Generated

Flow cytometric analysis found no difference in duodenal eosinophils or mast cells between functional dyspepsia patients and healthy controls, but high-dose PPI treatment reduced overall leukocyte proportions while increasing mast cells in FD patients.

Duodenal leukocytes, eosinophils, mast cells, and neutrophils measured by flow cytometry did not differ between 22 FD patients (Rome IV) and 27 healthy controls at baseline.
Four weeks of high-dose pantoprazole (40mg twice daily) in FD patients significantly decreased duodenal leukocyte proportions (8.85% to 4.44%, p=0.03) and increased mast cell proportions (2.45% to 3.16%, p=0.05), with no change in eosinophils or neutrophils.
Eosinophil-derived neurotoxin (EDN) release from duodenal biopsies was similar between FD and controls and did not change after PPI treatment.
In FD patients, duodenal eosinophil proportions correlated with biopsy EDN release (r=0.61, p=0.001) but not faecal EDN, whereas in controls the opposite pattern was observed, suggesting altered eosinophil degranulation in FD.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Duodenal immune activation including increased eosinophil and mast cell infiltration have previously been reported in functional dyspepsia (FD). However, detailed insights in the nature of this immune activation are lacking, as previous research focused on routine histological investigation¹.

Aims & Methods

We aimed to characterise duodenal innate immune cell populations in FD and investigate eosinophilic mediator release. Furthermore, we aimed to evaluate the potential anti-inflammatory effects of a high-dose proton pump inhibitor (PPI) course in FD. Patients with FD (Rome IV) and healthy controls (HC) were recruited to undergo upper GI endoscopy with duodenal biopsies, which was repeated in FD after 4 weeks of high-dose PPI (pantoprazole 40mg bid). Lamina propria leukocytes were isolated from fresh biopsies and stained with fluorescently labelled antibodies for subsequent flow cytometric analysis using an LSR Fortessa flow cytometer (BD). Leukocytes were gated as CD45⁺ cells within single viable (FVD780^-) cells. Within this population, eosinophils (Siglec8⁺, CD117^-, CD193⁺, SSC^high), mast cells (Siglec8⁺, CD117⁺) and neutrophils (CD16⁺, SSC^high) were expressed as percentage of leukocytes. Faecal samples were obtained from all participants and proteins were extracted². Eosinophil derived neurotoxin (EDN) was measured in duodenal biopsy supernatants and faecal protein extracts using ELISA (Diagnostics Development). Data were analysed in Prism by (non-)parametric tests depending on normality and calculation of Spearman’s correlation r.

Results

Data are available from 22 FD patients (18 female, mean ± SEM age 33 ± 3 years) and 27 HC (21 female, 29 ± 2 years). Duodenal leukocytes, eosinophils, mast cells and neutrophils were not different between patients and controls (Table). However, duodenal leukocyte proportions decreased in FD after PPI, with an opposite effect for mast cells. Duodenal eosinophil and neutrophil proportions remained unchanged after PPI. EDN released by duodenal biopsies was similar in FD and HC, without changes after PPI (Table). Similarly, no between- or within-group differences were found for faecal EDN. Eosinophil proportions in FD at both visits were significantly associated with EDN release from biopsies (r=0.61, p=0.001), but not faecal EDN (r=0.004, p=0.98). In contrast, faecal (r=0.44, p=0.03) but not supernatant EDN (r=0.33, p=0.1) was linked to duodenal eosinophils in controls.

Table: Between- (FD vs HC) and within-group (FD vs FD+PPI) comparisons.

Variable (mean ± SEM)	FD	HC	FD vs. HC (p-value)	FD + PPI	FD vs. FD + PPI (p-value)
Leukocytes (% viable cells)	8.85 ± 1.54	6.88 ± 0.9	0.35	4.44 ± 0.51	0.03
Eosinophils (% leukocytes)	2.83 ± 0.42	3.23 ± 0.24	0.20	2.40 ± 0.49	0.14
Mast cells (% leukocytes)	2.45 ± 0.19	2.78 ± 0.21	0.31	3.16 ± 0.32	0.05
Neutrophils (% leukocytes)	0.77 ± 0.13	0.83 ± 0.15	0.78	0.77 ± 0.07	0.97
Biopsy-released EDN (µg/g biopsy)	6.60 ± 1.29	6.24 ± 0.5	0.40	5.23 ± 0.81	0.52
Faecal EDN (µg/g faeces)	28.47 ± 6.81	45.59 ± 9.53	0.27	27.45 ± 6.74	0.68

Conclusion

Using flow cytometric evaluation of the duodenal mucosa, we found similar proportions of innate immune cells, including eosinophils and mast cells in FD patients compared to controls. However, immunomodulatory effects of a high-dose PPI course in FD included reduced leukocyte proportions and increased mast cells. A strong association between duodenal release of EDN and eosinophil numbers in patients but not controls, suggests altered eosinophil degranulation in FD, which warrants further investigation. Finally, faecal EDN levels were only linked to duodenal eosinophils in controls but not patients, limiting its suitability as a biomarker.

References

¹ Ceulemans et al. Front Neurosci 2022
² Peterson et al. Am J Gastro 2002

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

Breakthroughs in GORD and functional dyspepsia (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Naohisa Yahagi

TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

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Circulating microbiome: Hopes and pitfalls

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Li Ni

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Ahmed Naguib

UEG Presentation

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EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

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EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Marc Barthet 1, Naohisa Yahagi 2

Affiliations

1 Hopital Nord, Marseille, France

2 Keio University Cancer Center - Cancer Center, Keio University Cancer Center; Tokyo/JP, Tokyo, Japan

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Abstract

Event

UEG Week Berlin 2025

Session

Never waste a good disaster

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Naohisa Yahagi

TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

Antonino Spinelli

Circulating microbiome: Hopes and pitfalls

Jurgita Skieceviciene

Proposing faecal microbial transfer for IBS?

Reetta Satokari

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

Li Ni

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Ahmed Naguib

UEG Presentation

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TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

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TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

Silvio Laureti 1, Luigi Sofo 2, Alberta Cappelli 1, Francesco Colombo 3, Gaetano Luglio 4, Stefano Scaringi 5, Claudio Isopi 1, Franco Sacchetti 2, Giuseppe Clerico 6, Pier Giorgio Danelli 7, Michele Cricrì 4, Ferdinando Ficari 5, Lorenzo Gentilini 1, Alessandra Menon 8, Paolo Gionchetti 1, Gilberto Poggioli 1, Antonino Spinelli 9

Affiliations

1 IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

2 Policlinico Universitario Fondazione Agostino Gemelli IRCCS, Roma, Italy

3 L.Sacco University Hospital General Surgery II, Milano, Italy

4 Università Federico II, Napoli, Italy

5 Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy

6 IRCCS Humanitas Research Hospital, Rozzano, Italy

7 Università degli studi La Statale, Milano, Italy

8 Università degli Studi di Milano, Milan, Italy

9 Humanitas University, Rozzano Milano, Italy

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Abstract

Introduction

Complex perianal fistulas represent one of the most challenging manifestations of Crohn’s disease. Combined surgical and medical therapy with biologic drugs represents today the first-line treatment option, but its efficacy does not exceed 60% in terms of healing. Recently, new therapeutic approaches, such as autologous microfragmented adipose tissue (M-Fat) injection, have shown promising results. Indeed, a recent non-profit prospective pilot study on 15 patients has demonstrated that the local injection of M-Fat is a safe and promising “rescue therapy” for patients with multiresistant complex fistulizing Crohn’s disease (PCD), with a 66.7% rate of combined remission in such difficult patients. It has to be highlighted that the M-Fat injection is minimally invasive, with less risk of sphincteric damage and can be carried out in day-surgery setting.

Aims & Methods

The primary aim of this multicentre double-blind randomized controlled trial (ATTIC) is to evaluate the efficacy of the infiltration of M-Fat in the healing of perianal complex fistulas not-responding to treatment with biologics. Consecutive patients referring to the 6 investigation Centers for surgical treatment of persistent complex fistulizing PCD refractory to biosurgical approach were assessed for eligibility. After baseline pelvic magnetic resonance imaging, those included were submitted to surgical drainage with “cone-like” fistulectomy, and then randomized to receive a 15 to 20 cc local injection, at the internal orifice level and along fistula tracts, of M-Fat obtained by a lipoaspiration and processed with an enzyme-free technology (treatment group), or a suture placement and injection of 15 cc of saline solution at the internal orifice (control group). Clinical follow-up were conducted at 2, 4, 8, 12, and 24 weeks; at 24 weeks after surgery, pelvic magnetic resonance was obtained. Success was defined as “combined remission”, combination of clinical (absence of drainage upon gentle finger compression) and radiological healing (absence of residual collections > 3 mm). Clinical remission was defined as clinical healing of all external openings not confirmed at radiological assessment.

Results

An overall 92 patients were screened, and 66 (33 per group) completed the 24-week follow-up. A statistically significant difference in favour of the treatment group in terms of combined remission emerged at the primary endpoint at 24-week follow-up (control group, 18.18%; treatment group: 57.58%; p = 0.0020). No significant differences in clinical outcome measures were encountered at any of the other follow-up points. No significant differences emerged between the groups in terms of recurrence rate, complication rate, and number of adverse events. Clinical remission was 63.64% in the treatment group compared to 51.52% in the control group with no statistically significant difference (p > 0.05).

Conclusion

This multicentre double-blind randomized controlled trial demonstrates that the intraoperative injection of M-Fat, associated with surgical complete drainage of perianal sepsis, is safe, effective, and reproducible in healing complex multirefractory perianal Crohn's disease, while improving the quality of life and significantly reducing the risk of definitive oostomy.

Event

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Treatment of fistulas in Crohn's disease

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Naohisa Yahagi

TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

Antonino Spinelli

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Jurgita Skieceviciene

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Reetta Satokari

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

Li Ni

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Ahmed Naguib

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Circulating microbiome: Hopes and pitfalls

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Circulating microbiome: Hopes and pitfalls

Jurgita Skieceviciene 1

Affiliations

1 Lithuanian University of Health Sciences, Kaunas, Lithuania

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Abstract

Event

UEG Week Copenhagen 2023

Topics

Gut Microbiota Mechanisms & Personalised Medicine Pancreas

Session

Microbiome at GI interfaces

Published

2023

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EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Naohisa Yahagi

TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

Antonino Spinelli

Circulating microbiome: Hopes and pitfalls

Jurgita Skieceviciene

Proposing faecal microbial transfer for IBS?

Reetta Satokari

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

Li Ni

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Ahmed Naguib

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Proposing faecal microbial transfer for IBS?

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Proposing faecal microbial transfer for IBS?

Reetta Satokari 1

Affiliations

1 University of Helsinki Research Portal, Helsinki, Finland

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Abstract

Event

UEG Week Berlin 2025

Topics

Gut Microbiota Primary Care

Session

The art of making clinical research precise: Can we unlock the microbiome?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Naohisa Yahagi

TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

Antonino Spinelli

Circulating microbiome: Hopes and pitfalls

Jurgita Skieceviciene

Proposing faecal microbial transfer for IBS?

Reetta Satokari

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

Li Ni

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Ahmed Naguib

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

Ka Shing Cheung 1,2, Tao Lyu 1, Zijie Deng 1, Shaowei Han 1, Li Ni 1, Juan Wu 1, Jing Tong Tan 2, Ho Yu Ng 2, Wai Keung Leung 2, Wai-Kay Seto 1,2

Affiliations

1 The University of Hong Kong-Shenzhen Hospital, Shenzhen, China

2 The University of Hong Kong, Hong Kong, Hong Kong

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Abstract

Introduction

There are currently no studies comparing vonoprazan-dual, vonoprazan-triple therapies and classic bismuth quadruple therapy.

Aims & Methods

We aimed to compare efficacy of vonoprazan-dual or triple therapies and bismuth-quadruple therapy for treatment-naive Helicobacter pylori (HP) infection in Southern China, where primary resistance rates of clarithromycin and levofloxacin are >30%.
Between March 2022 and August 2023, treatment-naïve HP-infected adults were randomly assigned to receive one of the three 14-day regimens (1:1:1 ratio): vonoprazan-dual (VA-dual; vonoprazan 20mg twice daily and amoxicillin 1g thrice daily), vonoprazan-triple (VAC-triple; vonoprazan 20mg/amoxicillin 1g/clarithromycin 500mg twice daily), or bismuth-quadruple therapy containing bismuth, esomeprazole, tetracycline and metronidazole. Primary outcome was noninferiority in HP eradication, evaluated by UBT 4-6 weeks post-treatment by intention-to-treat (ITT) (based on all recruited subjects who took at least one dose of treatment regimen, and those lost to follow-up were considered as treatment failure cases), modified intention-to-treat (mITT) (based on patients who took at least one dose of the treatment and completed follow-up) and per-protocol (PP) analysis (based on subjects who completed 14-day treatment and rechecked UBT). Bonferroni-adjusted p-value of <0.017 was used to determine statistical significance. Primary outcome was noninferiority in HP eradication, evaluated by UBT 4-6 weeks post-treatment by intention-to-treat (ITT) and per-protocol (PP) analysis (based on subjects who completed 14-day treatment and rechecked UBT). Comparative non-inferiority between bismuth-quadruple and VA-dual or VAC-triple was assessed by one-sided μ test and derivation of a two-sided 95% confidence interval (CI), with noninferiority being determined by a lower 95% CI end more than –10% with a Bonferroni-adjusted p-value of <0.017. A two-sided p-value of 0.05 was used to define statistical significance for other analyses.

Results

298 subjects (mean age:35.7±8.4 years; male:134 [45.0%]; body mass index:23.2±3.5 kg/m²; VC-dual:100, VAC-triple:98, bismuth-quadruple:100) were enrolled, and 292 (98.0%) had UBT rechecked. ITT analysis showed both VA-dual (eradication rate of 96.0%) and VAC-triple therapies (95.9%) were non-inferior to bismuth-quadruple therapy (92.0%) (difference:4.0%, 95% CI:-2.9% to 11.5%, p<0.001; and 3.9%, 95% CI:-3.1% to 11.5%, p<0.001, respectively). mITT analysis also showed non-inferiority of VA-dual and VAC-triple therapies to bismuth-quadruple therapy (97.0% and 96.9% vs 95.8%, with difference:1.1% and 1.1%, p=0.002 and 0.002, respectively). Similar observation was noted for PP analysis (96.7% and 96.7% vs 97.4%, with difference:-0.7% and -0.7%, p=0.009 and 0.010, respectively) (Table 1). The frequency of adverse events was 39.0%, 56.1% and 71.0% in VA-dual, VAC-triple and bismuth-quadruple therapies, respectively.

Table 1. Helicobacter pylori eradication rates of vonoprazan-dual, vonoprazan-triple and bismuth-quadruple therapies

				VA-dual vs bismuth- quadruple therapy		VAC-triple vs bismuth- quadruple therapy		VA-dual vs VAC-triple therapy
	VA-dual therapy	VAC-triple therapy	Bismuth- quadruple therapy	Difference (95% CI)	Non- inferiority p-value	Difference (95% CI)	Non- inferiority p-value	Difference (95% CI)	Non- inferiority p-value
ITT	96.0% (96/100)	95.9% (94/98)	92.0% (92/100)	4.0% (-2.9% to 11.5%)	<0.001	3.9% (-3.1% to 11.5%)	<0.001	0.08% (-6.3% to 6.5%)	0.005
mITT	97.0% (96/99)	96.9% (94/97)	95.8% (92/96)	1.1% (-4.9% to 7.6%)	0.002	1.1% (-5.1% to 7.5%)	0.002	0.01% (-5.8% to 6.1%)	0.004
PP	96.7% (89/92)	96.7% (87/90)	97.4% (75/77)	-0.7% (-6.9% to 6.1%)	0.009	-0.7% (-7.1% to 6.0%)	0.010	0.01% (-6.3% to 6.5%)	0.006
Abbreviation: VA-dual, vonoprazan dual; VAC-triple, vonoprazan triple; CI, confidence interval; ITT, intention-to-treat analysis; mITT, modified intention-to-treat analysis; PP, per protocol analysis The p-values were adjusted for multiple comparisons using Bonferroni’s correction. The significance level was set at 0.05/3 = 0.017 for each comparison.

Conclusion

VA-dual and VA-triple therapies were non-inferior to bismuth-quadruple therapy in Southern China. Given the lower adverse effects and fewer antibiotic use, VA-dual therapy is the preferred first-line treatment for HP infection.

Disclosure

This study was supported by the National Natural Science Foundation of China (Grant No. 81903581), the Shenzhen Science and Technology Program (Grant Nos. JCYJ20190807150005699 and RCBS20200714115000009), the Shenzhen Key Medical Discipline Construction Fund (Grant No. SZXK059), the Shenzhen Key Laboratory of Prevention and Treatment of Severe Infections (Grant No. ZDSYS20200811142804014), and the Health Commission Grant of Guangdong Province, China (ref. no. B2021239).

Event

UEG Week Vienna 2024

Topics

Neurogastroenterology & Motility Stomach & H. Pylori

Submission format

Abstract

Session

Dyspepsia and H.pylori

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

EMR or ESD for duodenal adenoma: Too much recurrence and too much risk?

Naohisa Yahagi

TREATMENT OF CROHN'S COMPLEX PERIANAL FISTULAS WITH MICRO-FRAGMENTED AUTOLOGOUS ADIPOSE TISSUE INJECTION: AN ITALIAN MULTICENTER RANDOMIZED CONTROLLED TRIAL (ATTIC)

Antonino Spinelli

Circulating microbiome: Hopes and pitfalls

Jurgita Skieceviciene

Proposing faecal microbial transfer for IBS?

Reetta Satokari

VONOPRAZAN-DUAL AND TRIPLE THERAPIES WERE NON-INFERIOR TO BISMUTH-BASED QUADRUPLE THERAPY AS FIRST-LINE THERAPY FOR HELICOBACTER PYLORI INFECTION IN CHINA: A THREE-ARM, RANDOMIZED CLINICAL TRIAL

Li Ni

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Ahmed Naguib

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

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THE VALUE OF SERUM PRONEUROTENSIN AS A PREDICTOR OF CARDIOVASCULAR RISK IN NAFLD PATIENTS

Mona Ahmed Amin 1, Ula Al-Jarki 1, Dina Hesham Ahmed 1, Ahmed Naguib 1

Affiliations

1 Cairo University, Cairo, Egypt

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Abstract

Introduction

Cardiovascular disease (CVD) is the leading cause of death in NAFLD patients. Increased plasma proneurotensin (pro-NT) levels were found to identify the presence and severity of NAFLD. The association between pro-NT and incident major cardiovascular events has been confirmed.

Aims & Methods

To evaluate the association of serum pro-neurotensin with cardiovascular risk in NAFLD patients. A cross-sectional cohort included sixty patients with NAFLD and documented CVD, sixty patients with NAFLD without documented CVD and 60 healthy controls. Liver function tests, liver enzymes, lipid profile, fasting blood glucose, abdominal ultrasound and serum proneurotensin were done.

Results

Proneurotensin was significantly higher in the NAFLD group as compared to controls, P <0.0001. Proneurotensin levels were significantly higher in patients with established CVD in addition to NAFLD as compared to NAFLD only patients P <0.0001. Serum proneurotensin showed significant positive correlation with Framingham score and NAFLD Fibrosis Score P <0.0001. Reciever operating characteristic (ROC) curve demonstrated a cut-off value >24.5 ng/L for proneurotensin as a predictor of NAFLD with 64.2% sensitivity and 96.7% specificity, (AUC) = 0.862, P < 0.001. And a cut-off value >28.5 ng/L for proneurotensin as a predictor of CVD in NAFLD patients, with 83.3% sensitivity and 78.3% specificity, (AUC) = 0.854, P < 0.001.

Conclusion

serum proneurotensin is significantly higher in NAFLD patients established CVD than NAFLD only patients and healthy subjects. It can be considered as a marker of CVD risk in such patients

References

Ilaria Barchetta, Flavia Agata Cimini, Frida Leonetti, Danila Capoccia, Claudio Di Cristofano, Gianfranco Silecchia, Marju Orho-Melander, Olle Melander, Maria Gisella Cavallo; Increased Plasma Proneurotensin Levels Identify NAFLD in Adults With and Without Type 2 Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 6, 1 June 2018, Pages 2253–2260

Disclosure

nothing to disclose.

Event

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

Progress in liver disease biomarkers

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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