Publications by authors named "Dalekos G"
Background: Anakinra was approved by the European Medicines Agency and received Emergency Use Authorization by the United States Food and Drug Administration for patients with COVID-19 pneumonia at risk for severe respiratory failure (SRF) with blood levels of soluble urokinase plasminogen activator receptor (suPAR) ≥ 6 ng/mL. We report the final results of the phase II open-label single-arm SAVE trial in a large population.
Methods: Patients with COVID-19 pneumonia and suPAR levels ≥ 6 ng/mL received subcutaneous anakinra 100 mg once daily for 10 days.
Background: Biologic agents used in patients with inflammatory bowel diseases (IBD) may influence the pathophysiology of coexistent metabolic-dysfunction associated steatotic liver disease (MASLD). This study primarily aimed to evaluate the six-month effect of infliximab or vedolizumab vs. no biologics on presumed hepatic steatosis in patients with IBD.
View Article and Find Full Text PDFAutoimmune hepatitis (AIH) is a rare liver disease, of unknown origin, characterized by considerable heterogeneity. AIH can affect both sexes, of all ages, ethnicities and races. The revised Clinical Practice Guidelines (CPGs) of the Hellenic Association for the Study of the Liver aim to provide updated guidance to clinicians.
View Article and Find Full Text PDFPatients with sepsis differ in their clinical presentations and immune dysregulation in response to infection, but the fundamental processes that determine this heterogeneity remain elusive. Here, we aim to understand which types of immune dysregulation characterize patients with sepsis. To that end, we investigate sepsis pathogenesis in the context of two transcriptional states: one represents the immune response to eliminate pathogens (resistance, R) and the other is associated with systemic inflammation (SI).
View Article and Find Full Text PDFBackground & Aims: Liver stiffness measurement (LSM) has been shown to adequately predict outcomes in patients with liver disease. However, the value of LSM as a predictor of disease progression in autoimmune hepatitis (AIH) remains to be determined. This study aimed to evaluate the role of LSM as a predictor of disease progression and decompensation of cirrhosis in patients with AIH.
View Article and Find Full Text PDFObjectives: To investigate associations of the carriage of single nucleotide polymorphisms (SNPs) of proteins involved in the immune response of patients with brucellosis.
Methods: A case control study of patients with brucellosis upon WHO criteria. Blood genomic analysis was performed by RFLP- PCR for the detection of SNPs: i) at promoters -376 G > A (rs1800750); -308 G > A (rs 1,800,629); -238 G > A (rs361525) of the TNF gene, ii) at -896 A > G Asp299Gly (rs4986790) and -1196 C > T Thr399Ile (rs4986791) positions of the TLR-4 gene.
Objective: To investigate the metabolomic profiles associated with different immune activation states in sepsis patients.
Design: Subgroup analysis of the PROVIDE (a Personalized Randomized trial of Validation and restoration of Immune Dysfunction in severe infections and Sepsis) prospective clinical study.
Setting: Results of the PROVIDE study showed that patients with sepsis may be classified into three states of immune activation: 1) macrophage-activation-like syndrome (MALS) characterized by hyperinflammation, sepsis-induced immunoparalysis, and 3) unclassified or intermediate patients without severe immune dysregulation.
Article Synopsis
- The study looked at how patients with a liver disease called primary biliary cholangitis (PBC) respond to a treatment called ursodeoxycholic acid (UDCA).
- It found that many patients (33%) didn’t have a good response after one year, and those who lost their good response had a higher chance of needing a liver transplant or dying.
- The research showed that staying or getting back to a good response is important for improving long-term health.
Article Synopsis
- Researchers classified sepsis into four clinical phenotypes using a simplified algorithm based on six admission parameters in a study involving 1498 patients, including those with bacterial sepsis and severe COVID-19.
- The analysis found distinct characteristics and outcomes for the phenotypes, with Phenotype α showing low mortality risk and Phenotype δ having the highest mortality.
- The study concludes that this phenotyping method is effective for predicting outcomes in both bacterial sepsis and severe COVID-19, suggesting it could have important prognostic applications.
Objectives: It is suggested that sepsis may be classified into four clinical phenotypes, using an algorithm employing 29 admission parameters. We applied a simplified phenotyping algorithm among patients with bacterial sepsis and severe COVID-19 and assessed characteristics and outcomes of the derived phenotypes.
Design: Retrospective analysis of data from prospective clinical studies.
Introduction And Objectives: Autoimmune liver diseases (AILD) are rare causes hepatocellular carcinoma (HCC), and data on the efficacy and tolerability of anti-tumor therapies are scarce. This pan-European study aimed to assess outcomes in AILD-HCC patients treated with tyrosine kinase inhibitors (TKIs) or transarterial chemoembolization (TACE) compared with patients with more common HCC etiologies, including viral, alcoholic or non-alcoholic fatty liver disease.
Materials And Methods: 107 patients with HCC-AILD (AIH:55; PBC:52) treated at 13 European centres between 1996 and 2020 were included.
Article Synopsis
- Healthcare systems have problems because people are getting older, more people have long-term illnesses, and it's hard to pay for everything while making sure everyone gets good care.
- The current way healthcare works focuses too much on specialists, which means care can be scattered and not always helpful for patients.
- Internal medicine doctors should be the main doctors for complex cases in hospitals and work together with other healthcare providers to ensure patients get consistent care, especially for chronic illnesses.
Article Synopsis
- - The R-LIVER registry, initiated by the European Reference Network on Hepatological Diseases, analyzed the presentation and outcomes of autoimmune hepatitis (AIH) in 231 patients across six European centers over a year.
- - After 6 months, 50% of patients achieved complete biochemical response (CBR), with a rise to 63% by the 12-month mark, but only 27% managed to achieve this without steroids during the first year.
- - Results indicate significant variability in AIH treatment, with many patients experiencing treatment changes due to intolerance, and highlight the need for improved strategies given the low CBR rates and challenges in steroid withdrawal.
Dynamics of Liver Stiffness Measurement and Clinical Course of Primary Biliary Cholangitis.
Clin Gastroenterol Hepatol
December 2024
Article Synopsis
- The study investigates the prognostic value of changes in liver stiffness measurement (LSM) over time in patients with primary biliary cholangitis (PBC) who are being treated with ursodeoxycholic acid.
- It utilizes data from 3,078 patients over a 19-year period, finding that 59% of participants had an increase in LSM, which is linked to a higher risk of serious clinical events such as cirrhosis complications and liver transplants.
- The research concludes that monitoring LSM changes provides essential prognostic information, suggesting its potential as a valuable endpoint in clinical trials for PBC treatment.
Article Synopsis
- Detecting autoantibodies is crucial for diagnosing autoimmune hepatitis (AIH), especially in children where their specificity can be lower; recent research points to polyreactive IgG (pIgG) as a promising marker.
- A study, using samples from multiple European centers, found that pIgG had enhanced specificity and accuracy for diagnosing pediatric AIH compared to traditional antibodies like ANA and anti-SMA.
- pIgG distinguished AIH from other liver diseases with an AUC of 0.900, showing it was positive in a significant portion of pediatric patients and independent of their treatment response.
Background: Autoimmune hepatitis (AIH) is a relatively rare autoimmune disease with a strong genetic background. The patatin-like phospholipase domain-containing protein 3 () (38409 C/G) variant has been associated with hepatic inflammation and fibrosis in chronic hepatic diseases beyond metabolic dysfunction-associated steatotic liver disease (MASLD).
Aim: Our aim was to investigate the significance of variant in AIH.
Background And Aims: Chronic hepatitis delta represents a major global health burden. Clinical features of hepatitis D virus (HDV) infection vary largely between different regions worldwide. Treatment approaches are dependent on the approval status of distinct drugs and financial resources.
View Article and Find Full Text PDFWe aimed to evaluate heparin-binding protein (HBP) as a marker of prognosis of unfavorable outcome in COVID-19 pneumonia. This was a post hoc analysis of the SAVE clinical trial investigating anakinra treatment, guided by suPAR (soluble urokinase plasminogen activator receptor) levels ≥6 ng/mL, for the prevention of severe respiratory failure in hospitalized patients with COVID-19 pneumonia. Baseline HBP plasma levels were measured in 534 patients by fluorescence dry quantitative immunoassay using the Jet-iStar 800 analyzer.
View Article and Find Full Text PDFBackground: We recently developed a simple novel index called fibrosis 6 (FIB-6) using machine learning data analysis. We aimed to evaluate its performance in the diagnosis of liver fibrosis and cirrhosis in chronic hepatitis B (CHB).
Methods: A retrospective observational analysis of data was obtained from seven countries (Egypt, Kingdom of Saudi Arabia (KSA), Turkey, Greece, Oman, Qatar, and Jordan) of CHB patients.
Article Synopsis
- Researchers studied how different immune endotypes affect responses to anakinra treatment in patients with severe pneumonia caused by COVID-19 during the SAVE-MORE trial.
- The study found that many patients transitioned between immune endotypes during treatment, with anakinra helping those with the adaptive endotype to maintain better outcomes.
- Anakinra also reduced the risk of severe respiratory failure in patients with a coagulopathic endotype compared to placebo, indicating its potential benefits in managing sepsis-related conditions.
Background And Aims: Metabolomics is used to predict, diagnose, and monitor metabolic disorders but altered metabolomic signatures have also been reported in diverse diseases, including autoimmune disorders. However, the metabolomic profile in autoimmune hepatitis (AIH) has not been investigated in depth. Therefore, we investigated the metabolomic signature of AIH and its significance as a diagnostic and pathogenetic tool.
View Article and Find Full Text PDFArticle Synopsis
- *Eighty patients were analyzed, with 40 receiving steroids and 40 receiving standard care; MRI scans and clinical evaluations were conducted.
- *Results showed that only 7.5% of steroid-treated patients developed osteonecrosis, while none in the non-steroid group did, indicating a lower risk than expected but still necessitating careful monitoring.
Article Synopsis
- The study examines whether adding the macrolide antibiotic clarithromycin to β-lactam antibiotics can improve early clinical responses in hospitalized patients with community-acquired pneumonia, based on previous observational studies rather than randomized trials.
- Conducted as a phase 3 double-blind randomized controlled trial in Greece, the research involved adult patients with severe pneumonia who were given either standard care plus a placebo or standard care plus clarithromycin for seven days.
- The primary outcome measured included a significant improvement in respiratory symptoms and reduction in inflammatory response after 72 hours of treatment, with both groups being kept unaware of their allocated treatment for unbiased results.