Publications by authors named "Michela E Burlone"
Metabolic dysfunction-associated steatohepatitis (MASH) is the replacement term for what used to be called nonalcoholic steatohepatitis (NASH). It is characterized by inflammation and injury of the liver in the presence of cardiometabolic risk factors and may eventually result in the development of hepatocellular carcinoma (HCC), the most common form of primary liver cancer. Several pathogenic mechanisms are involved in the transition from MASH to HCC, encompassing metabolic injury, inflammation, immune dysregulation and fibrosis.
View Article and Find Full Text PDFBackground: Whether the etiology of underlying liver disease represents a prognostic factor in patients with hepatocellular carcinoma (HCC) treated with lenvatinib is still a matter of debate. This study investigates whether the viral etiology of HCC plays a prognostic role in overall survival (OS). Methods: Data derived from a multicenter series of 313 HCC patients treated with lenvatinib between 2019 and 2022 were analyzed.
View Article and Find Full Text PDFPatients with cirrhosis are at risk of hepatocellular carcinoma (HCC) development and, according to current guidelines, should undergo surveillance by ultrasound at six month intervals. Due to the known limitations of surveillance strategies based on ultrasonography, the use of tumor biomarkers, although debated, is common practice in many centers. The aim of the study was to identify the best cut-off value for one of such biomarkers, protein induced by vitamin K absence, or antagonist-II (PIVKA-II).
View Article and Find Full Text PDFBackground And Aims: Sex hormones are widely recognised to act as protective factors against several viral infections. Specifically, females infected by the hepatitis C virus display higher clearance rates and reduced disease progression than those found in males. Through modulation of particle release and spread, 17β-oestradiol controls HCV's life cycle.
View Article and Find Full Text PDFBackground: Genetic predisposition to accumulate liver fat (expressed by a polygenic risk score, GRS, based on the number of at-risk alleles of PNPLA3, TM6SF2, MBOAT7 and GCKR) may influence the probability of developing hepatocellular carcinoma (HCC) after hepatitis C treatment. Whether this holds true taking into account carriage of the HSD17B13:TA splice variant, also affecting lipogenesis, and achievement of viral clearance (SVR), is unknown.
Methods: PNPLA3, TM6SF2, MBOAT7, GCKR and HSD17B13 variants were determined in a cohort of 328 cirrhotic patients free of HCC before starting treatment with direct acting antivirals (DAA).
Objective: In this study we aimed to compare patient outcomes between the use of transarterial radioembolization (TARE) and sorafenib in patients with hepatocellular carcinoma (HCC) and intrahepatic portal vein tumor thrombosis (PVTT).
Methods: A total of 65 patients with HCC and intrahepatic PVTT treated in five Italian hospitals between 2012 and 2018 were included in the analysis. Those with any previous treatment, extension of PVTT to the main portal tract and extrahepatic involvement were excluded.
Article Synopsis
- Circulating periostin may serve as a biomarker for non-alcoholic fatty liver disease (NAFLD), but its relevance in Caucasian populations needs more investigation.
- In a study of 74 NAFLD patients, no significant differences in plasma periostin levels were observed across different patient groups based on age, liver fibrosis, or steatosis, although levels were notably higher in those with hepatocellular carcinoma (HCC).
- Genetic factors, particularly certain haplotypes, could influence periostin levels, suggesting a need for caution in considering periostin antagonists as a treatment option for NAFLD, while highlighting its potential in managing NAFLD-related HCC.
Article Synopsis
- The study evaluates Gas6, sAxl, and sMer as potential biomarkers for detecting pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) in patients with systemic sclerosis (SS) and scleroderma spectrum disorders (SSD).
- Nineteen patients were identified with pulmonary hypertension (14 specifically with PAH), while 39 had ILD, and specific plasma biomarkers showed significant differences based on these conditions.
- Plasma sMer levels were higher in PAH patients, while Gas6 and sAxl levels varied with ILD severity, indicating their potential utility for identifying these cardiopulmonary complications in SS and SSD.
Article Synopsis
- A specific gene change (rs738409) is linked to more severe liver disease and the risk of developing liver cancer (HCC) in patients with nonalcoholic fatty liver disease, and another variant (rs72613567:TA) may reduce this risk.
- The study involved comparing 110 HCC patients with hepatitis C to three non-HCC patients matched by age and sex, analyzing genetic variants to assess their impact on disease severity.
- Results indicated that having certain genetic combinations increases the risk of severe liver disease and HCC, suggesting that understanding these gene interactions could help identify high-risk patients in the future.
The severity of fatty liver at ultrasound has been associated with QT length, a finding invoked to explain the excess cardiovascular risk of patients with fatty liver. However, the ability of ultrasound to stage accurately the severity of fatty liver is limited, with fibrosis a major confounder. Here, we aimed to verify the alleged relationship between fat liver content and QT length using a technique apt at discriminating steatosis from fibrosis noninvasively, i.
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- Stereotactic body radiation therapy (SBRT) has shown potential as a more effective treatment for advanced hepatocellular carcinoma (HCC) compared to the standard drug sorafenib, particularly in terms of overall survival rates.
- A study analyzed data from 1,023 patients, revealing that those who received SBRT had a median overall survival of 18.1 months versus 8.8 months for those on sorafenib.
- SBRT particularly improved survival in patients with intrahepatic lesions and extrahepatic metastases, but did not show benefits for patients with portal vein thrombosis.
Article Synopsis
- Liver fibrosis is characterized by the buildup of extracellular matrix components, primarily from activated hepatic stellate cells, due to chronic liver injury repair.
- New noninvasive methods, such as potential biomarkers like Gas6 and its receptors (Tyro3, Axl, and MERTK), are being researched to assess liver fibrosis progression without the need for biopsies.
- While current findings suggest that these biomarkers could aid in monitoring liver disease and may even serve as a therapeutic target, more extensive validation studies are still needed to confirm their effectiveness and safety.
Introduction/objective: In the present paper, we aimed to test the value of the red cell distribution width (RDW) coefficient of variation as a candidate biomarker for pulmonary arterial hypertension (PAH) in patients with connective tissue disorders (CTD), correlating it with the degree of cardiopulmonary impairment in these patients.
Methods: The study population included = 141 patients with CTD and = 59 patients affected by pulmonary hypertension of other etiologies, all referred to the Pulmonary Hypertension Clinic of the Cardiology Division of an Academic Hospital in Northern Italy for evaluation (including right catheterization). Clinical, instrumental, and laboratory data were collected and related to RDW and other full blood count indexes.
Background: Hepatocellular carcinoma (HCC) is increasing globally. Prognostic biomarkers are urgently needed to guide treatment and reduce mortality. Tumour-derived circulating cell-free DNA (ctDNA) is a novel, minimally invasive means of determining genetic alterations in cancer.
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- The study investigates how antiviral treatment affects glucose metabolism in HCV-infected patients, focusing on those without a prior diabetes diagnosis.
- Results show that after treatment, significant improvements in insulin resistance and overall glucose levels occurred, with a shift from abnormal to normal glucose tolerance in many patients.
- The findings suggest that effective antiviral therapy not only helps manage diabetes but also improves subtle alterations in glucose metabolism among HCV patients.
Recent evidence implicates adaptive immunity as a key player in the mechanisms supporting hepatic inflammation during the progression of nonalcoholic fatty liver disease (NAFLD). In these settings, patients with NAFLD often show an increase in the circulating levels of antibodies against oxidative stress-derived epitopes (OSE). Nonetheless, the actual role of humoral immunity in NAFLD is still unclear.
View Article and Find Full Text PDFBackground: Level I evidence supports the use of sorafenib in patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma, where heterogeneity in efficacy exists due to varying clinicopathologic features of the disease.
Aim: We evaluated whether prior treatment with curative or locoregional therapies influences sorafenib-specific survival.
Methods: From a prospective data set of 785 consecutive patients from international specialist centres, 264 patients (34%) were treatment naïve (TN) and 521 (66%) were pre-treated (PT), most frequently with transarterial chemoembolization ( = 413; 79%).
Background: Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension.
Methods: Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography.
Article Synopsis
- The study investigates the effectiveness of sorafenib in treating hepatocellular carcinoma (HCC) and how baseline inflammatory markers and treatment side effects relate to survival outcomes.
- A total of 442 patients were analyzed, revealing that prior treatment history, specific scores (CLIP), and blood parameters (like RDW and NLR) significantly influence survival, while experiencing diarrhea during treatment correlated with longer survival.
- The research introduces a new prognostic tool combining CLIP score and RDW, which proved to be highly accurate in predicting survival at 3 and 12 months for patients undergoing sorafenib therapy.
Background & Aims: Oestrogen and oestrogen-mediated signalling protect from hepatitis C virus through incompletely understood mechanisms. We aimed to ascertain which phase(s) of hepatitis C virus life cycle is/are affected by oestrogens.
Methods: Huh7 cells infected with the JFH1 virus (genotype 2a) were exposed to dehydroepiandrosterone, testosterone, progesterone and 17β-estradiol (tested with/without its receptor antagonist fulvestrant).
Background & Aims: Overall survival (OS) is a composite clinical endpoint in hepatocellular carcinoma (HCC) due to the mutual influence of cirrhosis and active malignancy in dictating patient's mortality. The ALBI grade is a recently described index of liver dysfunction in hepatocellular carcinoma, based solely on albumin and bilirubin levels. Whilst accurate, this score lacks cross-validation, especially in intermediate stage HCC, where OS is highly heterogeneous.
View Article and Find Full Text PDFInfluence of age on sex-related differences among patients with hepatitis C.
Eur J Gastroenterol Hepatol
September 2016
Introduction: Sorafenib, an oral multikinase inhibitor, is the only targeted agent approved for the treatment of patients with hepatocellular carcinoma (HCC) after demonstration to increase overall survival compared to placebo in two randomized phase III study. GIDEON (Global Investigation of therapeutic DEcisions in HCC and Of its treatment with sorafeNib) is the largest, global, non-interventional, prospective study of patients with uHCC (n>3200) treated with sorafenib in real-life clinical practice conditions. Here we report the final analysis of safety and efficacy in the Italian cohort of patients.
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- The red cell distribution width (RDW) is identified as a significant biomarker for early mortality in various diseases, and this study aims to assess its effectiveness in predicting survival in hepatocellular carcinoma patients.
- The research involved analyzing RDW levels at diagnosis in two patient groups (208 in a training cohort and 106 in a validation cohort) to establish a prognostic index using Cox proportional hazards modeling.
- The findings reveal that patients with RDW levels ≤14.6% had significantly longer median survival times compared to those with higher RDW, confirming RDW as a strong independent predictor of survival in hepatocellular carcinoma.
Background: Alcohol is a major determinant of the outcome of chronic hepatitis C virus (HCV) infection, but self-reported drinking habits lack reliability. We hypothesized that carriage of high-repetition variants (HRV) of the variable number of tandem repeats (VNTR) in exon III of the dopamine receptor D4 gene, linked to binge-drinking and risk-seeking behavior, might be a proxy measure of alcohol consumption, and aimed to verify whether it may affect histologic outcome.
Methods: A cohort of HCV patients with normal or near-normal aminotransferases (N = 128) underwent a liver biopsy as part of diagnostic work-up.