Publications by authors named "E Culver"
Background: IgG4-related cholangitis (IgG4-SC) and primary sclerosing cholangitis (PSC) are chronic fibro-inflammatory hepatobiliary conditions, with genetic, environmental, and immunologic risk factors, in which epigenetic alterations may provide insights into pathophysiology and novel biomarkers. This study is the first to assess methylation signatures in IgG4-SC.
Results: Whole blood DNA methylation profiling and genotyping was performed in 264 individuals; 47 with IgG4-SC, 65 with PSC, 64 with ulcerative colitis (UC), and 88 healthy controls.
Immune-mediated liver and biliary conditions, such as IgG4-related pancreatobiliary disease (IgG4-PB) and a subset of primary sclerosing cholangitis (PSC- high(h)IgG4), exhibit increased IgG4 levels in the blood. The relative expression of IgG4+ and IgG1+ B cells in the blood and the expression of complement and Fc receptors on these IgG1+ and IgG4+ B cells in IgG4-PB and PSC have not been previously described. We hypothesised that the patterns of expression of these cells and their receptors would differ, are relevant to disease pathogenesis and may represent therapeutic targets.
View Article and Find Full Text PDFBackground & Aims: Noninvasive tests (NITs) for ruling-out clinical significant portal hypertension (CSPH) and high-risk varices (HRVs) in patients with primary biliary cholangitis (PBC) and compensated advanced chronic liver disease (cACLD) are lacking. We evaluated NITs in these patients and the influence of cholestasis on their performance.
Methods: Consecutive patients from the "Italian PBC registry" and 2 United Kingdom large-volume PBC referral centers with upper endoscopy within 6 months from biochemical evaluation and transient elastography were included.
Article Synopsis
- IgG4-related disease is a chronic immune disorder with no current approved treatment, and inebilizumab, which targets CD19+ B cells, is being tested as a potential therapy.
- In a phase 3 trial, 135 adults with active IgG4-related disease were randomly assigned to receive either inebilizumab or a placebo, and the primary measure was time until the first disease flare.
- Results showed that patients receiving inebilizumab had significantly fewer disease flares (10% vs. 60% in the placebo group), lower annual flare rates, and higher rates of complete remission without treatment compared to those in the placebo group.
Article Synopsis
- Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have a significant risk of developing colorectal cancer, and there's no consensus on the best surveillance methods.
- A study analyzed 91 patients with PSC and IBD over ten years to evaluate how effective chromoendoscopy and high-definition endoscopy were in detecting neoplastic lesions during regular check-ups.
- Results showed that chromoendoscopy greatly increased the detection rate of neoplasia (by 5.58 times), while high-definition endoscopy also improved detection, but its significance diminished when factoring in chromoendoscopy.