European journal of clinical investigation
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Eur. J. Clin. Invest. · Apr 2018
ReviewEpigenetic changes and their implications in autoimmune hepatitis.
The genetic risk of autoimmune hepatitis is insufficient to explain the observed risk, and epigenetic changes may explain disparities in disease occurrence in different populations within and between countries. The goal of this review was to examine how epigenetic changes induced by the environment or inherited as a phenotypic trait may affect autoimmune hepatitis and be amenable to therapeutic intervention. ⋯ Potentially reversible epigenetic changes may affect the occurrence and outcome of autoimmune hepatitis, and investigations are warranted to determine the nature of these changes, key genomic targets, and feasible interventions and their consequences.
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Eur. J. Clin. Invest. · Apr 2018
ReviewPTH, vitamin D, and the FGF-23-klotho axis and heart: Going beyond the confines of nephrology.
Profound disturbances in mineral metabolism are closely linked to the progression of chronic kidney disease. However, increasing clinical and experimental evidence indicates that alterations in phosphate homoeostasis could have an even stronger impact on the heart. ⋯ Among all mineral components, an increase in systemic FGF-23 levels is considered to have the greatest CV impact and risk. However, it is quite possible that many intracellular mechanisms mediated by FGF-23, especially those related to cardiomyocyte function, remain to be discovered.
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Eur. J. Clin. Invest. · Mar 2018
Soluble ST2 in end-stage heart failure, before and after support with a left ventricular assist device.
The interleukin-33 (IL-33)/suppressor of tumorigenicity 2 (ST2) pathway is suggested to play an important role in fibrosis, remodelling and the progression of heart failure (HF). Increased soluble (sST2) levels are associated with adverse outcome in the average HF population. Less is known about sST2 levels in end-stage HF. Therefore, we studied sST2 levels in end-stage HF and the effect of unloading by left ventricular assist device (LVAD) support on sST2 levels. ⋯ Levels of sST2 are elevated in end-stage HF patients with variability that suggests multiple inputs to a pro-inflammatory and pro-fibrotic pathway. Cardiogenic shock and increased C-reactive protein levels are associated with higher sST2 levels. LVAD support results in a significant drop in sST2 levels with normalization within 3 months postimplantation. This suggests that LVAD support leads to lessening of fibrosis and inflammation, which might eventually be used to target medical policy: explantation of the LVAD versus permanent use or cardiac transplantation.
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Eur. J. Clin. Invest. · Mar 2018
Randomized Controlled TrialThe effects of fish oil on gene expression in patients with polycystic ovary syndrome.
This study was conducted to determine the effects of fish oil administration on gene expression related to insulin, lipid and inflammation in women with polycystic ovary syndrome (PCOS). ⋯ Overall, fish oil supplementation for 12 weeks to subjects with PCOS significantly improved gene expression of PPAR-γ, IL-1 and IL-8, but did not influence gene expression of LP(a), LDLR, GLUT-1, TNF-α and TGF-β.