Abstract：
:Several hepatobiliary diseases appear to be mediated by the host immune response. They can be subdivided into those in which the immune reaction is against an infectious agent such as hepatitis viruses, those in which the immune reaction appears to be against an autoantigen expressed on hepatobiliary cells, and those due to alloimmunity. The existence of autoimmune liver diseases indicates a breakdown in the mechanisms responsible for self-tolerance. In HBV infection, the hepatocellular necrosis appears to be mediated by the host immune response against viral antigens expressed on the membranes of infected hepatocytes. Autoimmune chronic active hepatitis can be subdivided on the basis of differences in circulating autoantibodies. In classic type I autoimmune chronic hepatitis, autoantibodies are directed against non-organ- and non-species-specific antigens. Thus, they are unlikely to be involved in pathogenesis. In contrast, type II autoimmune chronic hepatitis is characterized by antibodies against specific cytochrome P-450 isoenzymes that appear to be expressed on the surface membrane of hepatocytes. Immunogenic cytochrome P-450 also can be induced by drug metabolism and haptenation. This indicates that environmental or medicinal xenobiotics may initiate autoimmune liver damage. Primary biliary cirrhosis is characterized by T-cell-mediated inflammation and destruction of interlobular and septal bile ducts and antibodies specific for epitopes of the 2-oxo-acid dehydrogenase multienzyme complex of mitochondria. The histopathologic lesion NSDC also is observed in alloimmune-mediated diseases such as CGVHD and rejection of liver allografts. PSC may be mediated by an immune response against endothelial cells of the peribiliary capillary plexus, with secondary reactions to bile duct epithelial cell antigens. The pathogenesis of alcoholic liver disease is multifactorial, but one component involves an immune response to acetaldehyde-protein adducts. Secondary sensitization of cell-mediated effector mechanisms, endothelial damage, and secretion of noxious cytokines appear to be involved in pathogenesis.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Vierling JMsubject
Has Abstractpub_date
1992-06-01 00:00:00pages
427-49issue
2eissn
0889-8553issn
1558-1942journal_volume
21pub_type
杂志文章,评审abstract：:Although many mechanisms remain unclear, a large body of evidence indicates that several dietary and lifestyle factors are likely to have a major influence on the risk of colon cancer. Physical inactivity, excess body weight, and a central deposition of adiposity are consistent risk factors. Overconsumption of energy ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(02)00057-2
更新日期：2002-12-01 00:00:00
abstract：:Autoimmune pancreatitis (AIP) is steroid-responsive fibroinflammatory disorder of the pancreas. There are 2 distinct subtypes of AIP, types 1 and 2. Type 1 is associated with systemic immunoglobulin (Ig)G4 disease and may affect multiple organs in the body. Type 2 is confined to the pancreas and shows an association w...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.04.007
更新日期：2018-09-01 00:00:00
abstract：:Anal cancer is rare and this helps to explain why anal pre-neoplastic conditions are poorly understood, especially with regard to their natural history and management. Anal intraepithelial neoplasia is closely linked to human papillomavirus infection and is particularly common in homosexuals and in immunosuppressed pa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.08.001
更新日期：2007-12-01 00:00:00
abstract：:Biotherapeutic agents offer unique advantages over traditional treatments for infectious diarrhea, and several have been shown to be effective (Table 4). These therapeutic microbial agents are most effective in types of infectious diseases that are associated with a disruption of the normal intestinal microecology (e....
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70213-2
更新日期：2001-09-01 00:00:00
abstract：:Capsule endoscopy is a relatively new technology available in the investigation of IBD. Its place in the algorithm of evaluating IBD is being refined. Capsule endoscopy has the ability to visualize the entire SB with very few complications. It is a sensitive test for the diagnosis of mucosal changes, but should be vie...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2012.01.005
更新日期：2012-06-01 00:00:00
abstract：:Gastric cancers are a histologically heterogenous group of neoplasms arising from unique epidemiologic and molecular backgrounds. There is accumulating evidence that the intestinal type of gastric adenocarcinoma develops through a multistep process beginning with chronic gastritis triggered primarily by Helicobacter p...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2013.01.004
更新日期：2013-06-01 00:00:00
abstract：:This brief review summarizes the physiology and pharmacology of eicosanoids and describes how they have been tested for possible application in liver disease and transplantation. The objective is to trace the stepwise application from the laboratory to the bedside. Although many questions remain to be answered, the ob...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70254-5
更新日期：1996-06-01 00:00:00
abstract：:Radiation therapy (RT) has been used to treat cancers for more than a century. Recent randomized trials have helped clarify the treatment recommendations in the use of RT for colorectal cancers. This article reviews these trials to illustrate key concepts, places these trials in perspective, and provides direction for...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.12.010
更新日期：2008-03-01 00:00:00
abstract：:Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Asia and Latin America. Of 4 million people infected in the United States, a large percentage are immigrants from developing coun...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70263-6
更新日期：1996-09-01 00:00:00
abstract：:Being the final pathway for chyme and digestive residues, the colorectum influences bowel function critically. The most important and relevant symptoms of colonic dysfunction are diarrhea, constipation, urgency, and pain. Despite the effects of many investigators, over several decades, the motor physiology of the huma...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70369-1
更新日期：1996-03-01 00:00:00
abstract：:Gallstones are common with prevalences as high as 60% to 70% in American Indians and 10% to 15% in white adults of developed countries. Ethnic differences abound with a reduced frequency in black Americans and those from East Asia, while being rare in sub-Saharan Africa. Certain risk factors for gallstones are immutab...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2010.02.003
更新日期：2010-06-01 00:00:00
abstract：:Because functional bowel disorders have no reliable markers, they must be defined by their symptoms. The various constellations of symptoms (syndromes) may have different mechanisms, differential diagnoses, and treatments. Therefore, precise classification is important on clinical and scientific grounds. Functional bo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-06-01 00:00:00
abstract：:CP remains a challenging disease. Endoscopic and surgical management, along with antioxidants, have helped in reducing chronic pain. Management of exocrine and endocrine insufficiency forms the cornerstone for improving nutrition in these patients. Newer therapeutic targets that will transcend the management of CP bey...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.12.009
更新日期：2012-03-01 00:00:00
abstract：:Endoscopic retrograde cholangiopancreatography is an effective platform for a variety of therapies in the management of benign and malignant disease of the pancreas. Over the last 50 years, endotherapy has evolved into the first-line therapy in the majority of acute and chronic inflammatory diseases of the pancreas. A...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2015.10.009
更新日期：2016-03-01 00:00:00
abstract：:Dramatic refinements in CT technology are resulting in improved evaluation of the liver, pancreas, and gastrointestinal tract. Further clinical trials are necessary to compare the relative merits of CT versus MR imaging and endoscopic ultrasonography in a wide variety of gastrointestinal diseases. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-06-01 00:00:00
abstract：:The health care burden of hepatitis C virus (HCV) infection is projected to continue to increase over the next two decades, so improving the efficacy of anti-HCV therapy has the potential to significantly affect health care utilization associated with the disease. Adherence to standard combination therapy and maintain...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.gtc.2003.12.003
更新日期：2004-03-01 00:00:00
abstract：:Esophageal high-resolution manometry (HRM) improves the management of patients with nonobstructive dysphagia. It has increased the diagnostic yield for detecting achalasia and defined three clinically relevant achalasia subtypes. Esophagogastric junction (EGJ) outflow obstruction, defined as an impaired EGJ relaxation...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.09.006
更新日期：2011-12-01 00:00:00
abstract：:Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intesti...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.01.008
更新日期：2018-06-01 00:00:00
abstract：:In conclusion, H. pylori infection can be detected by a variety of methods. The simplest, least expensive noninvasive method is serologic testing. Unfortunately, positive serology can only presume current infection. Urea breath testing is also noninvasive and is positive only in the setting of current infection; it is...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-03-01 00:00:00
abstract：:HCV in the East is a complex scenario with prevalence rates of 0.5% to as high as 4.7%, and variable distributions of genotypes, with a dominance of genotype 1b in East Asia, genotype 3 in South Asia and South East Asia, and genotype 6 in Indochina. Approvals for the new oral directing antiviral agents (DAAs), in the ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2015.07.007
更新日期：2015-12-01 00:00:00
abstract：:Hepatic injury due to chemicals or natural toxins may occur from occupational, household, or environmental exposure. The liver may dominate the syndrome of toxicity from such agents as carbon tetrachloride, poison mushrooms, and toxic alkaloids, or may be only one facet of more generalized toxicity. The entire histolo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:The application of EUS has improved the way we evaluate and manage patients with rectal cancer. EUS has substantially greater sensitivity than CT in detecting advanced T stage tumors. Such improved sensitivity results in changes in preoperative therapy that would not otherwise have occurred without EUS. Although the a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(02)00050-x
更新日期：2002-12-01 00:00:00
abstract：:Overall, fecal markers have been found to be more accurate than serum markers. However, fecal markers are not specific for IBD and may be elevated in a range of organic conditions. Fecal calprotectin and lactoferrin can still differentiate inflammatory disease from functional bowel disorders. Comparison studies have f...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2012.01.007
更新日期：2012-06-01 00:00:00
abstract：:Hereditary pancreatitis is a clinical condition in which typical pancreatitis is associated with an inheritance pattern strongly suggestive of an autosomal dominant trait. Different variants have been described, some with aminoaciduria and some with ductal anomalies. Recurrent attacks are typical and lead to complicat...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-12-01 00:00:00
abstract：:The goal of antiviral treatment of chronic hepatitis B is to prevent the complications of cirrhosis, hepatic decompensation, HCC, and death. Because these clinical outcomes may take a long period of time to develop, it is important to use intermediate or surrogate end points to evaluate the efficacy and response to an...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.06.004
更新日期：2011-09-01 00:00:00
abstract：:QOL assessment in oncology has made great strides in recent years. There was a difficult time initially, during which QOL tools were "thrown in" to many clinical trials as an afterthought, without a pre-specified scientific question. As expected from such a scattershot approach, the results were underwhelming and disa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2005.12.010
更新日期：2006-03-01 00:00:00
abstract：:Many disorders of the gastrointestinal tract have cutaneous manifestations. Thus, a careful examination of the skin may uncover clues to underlying diseases of the liver, gastrointestinal tract, and pancreas. This article explores the alimentary-cutaneous relationship. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70023-6
更新日期：1998-09-01 00:00:00
abstract：:Primary prevention of colonic adenomas and cancer through dietary interventions or chemoprevention has great appeal. This article discusses primary prevention goals and promising nutritional or chemopreventive strategies. There is substantial observational evidence that diets high in total calories and fat and or low ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(02)00011-0
更新日期：2002-06-01 00:00:00
abstract：:The development of colorectal neoplasia originates from normal colonic mucosa, progresses to the adenomatous polyp, and later may evolve into carcinoma. This procession of histologic change can be defined by a series of successive waves of clonal expansion that contain certain genetic alterations. These genetic altera...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70272-7
更新日期：1996-12-01 00:00:00
abstract：:The role of hormones and growth factors in the pathogenesis and therapy of colon cancer is biologically intricate and medically important. The effects of the previously described hormones and growth factors on normal and neoplastic colonic growth and development suggest the mechanisms by which hormonal alteration migh...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-12-01 00:00:00
