891 PIVOT ROLE OF PAI 1 4G4G IN NON CIRR
POSTERS
891
PIVOT ROLE OF PAI 1 4G4G IN NON-CIRRHOTIC PORTAL VEIN
THROMBOSIS AND BUDD-CHIARI SYNDROME
M. D’Amico1 , M. Niceta2 , P. Sammarco2 , R. Virdone3 , E. Sinagra1 .
1
Gastroenterology Unit, V. Cervello Hospital, Palermo, Italy; 2 Genetics,
V. Cervello Hospital, Palermo, Italy; 3 Internal Medicine, V. Cervello
Hospital, Palermo, Italy, Palermo, Italy
E-mail: mario.dami@libero.it
Background and Aim: Thrombophilic genetic factors (TGFs) have
been shown to be a risk factor for deep venous thrombosis in
different districts. We showed recently that PAI1 4G4G and MTHFR
C677 TT were significantly more frequent both in hepatocellular
carcinoma (HCC) and portal vein thrombosis (PVT) in patients with
liver cirrhosis. The aim of our study was to evaluate PAI1 4G4G,
MTHFR C677 TT, V Leiden Q506, and prothrombin G20210A, as risk
factors for PVT or Budd-Chiari Syndrome (BCS) in patients without
liver cirrhosis or HCC.
Materials and methods: 53 patients with PVT of which 20 with
chronic myeloproliferative diseases (CMPD), 32 BCS of which 17
with CMPD, 96 patients with CMPD without PVT or BCS and 94
PLT donors healthy controls (HC) were consecutively enrolled. The
TGFs studied were analysed in relation to the presence of PVT or
BCS. After univariate analysis, we selected each significant TGF as
independent variable, to perform multivariate logistic regression
analysis using PVT, BCS and CMPD as dependent variable anyone of
which significantly related to one or more TGFs.
Results: We found that PAI 1 4G4G homozygosis and the presence
of more than one TGF were significantly (p < 0.005) more frequent in
patients with PVT and BCS vs HC. MTHFR C677 TT homozygosis was
significant different (p < 0.005) in PVT group vs HC and V Leiden
Q506 was significant (p < 0.005) in BCS vs HC. The synthesis of
3 logistic regression analysis for any disease studied showed the
significant (p < 0.05) value of: PAI1 4G4G in PVT, BCS and CMPD,
MTHFR 677TT in PVT and V Leiden Q506 in BCS.
Conclusion: Our results show for the first time that PAI1 4G4G
plays a significant role in PVT and BCS. The role of MTHFR 677TT
was confirmed in PVT even without chronic liver diseases. We
hypothesize that the significant relation of PAI1 4G4G with CMPD
may indicate a potential pathogenetic role of this factor through
microvascular thrombosis and fibrogenesis; this relation could also
be an explanation of frequent thrombotic events in CMPD.
892
URSODEOXYCHOLIC ACID (UDCA) IN THE TREATMENT
OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP):
A SYSTEMATIC REVIEW AND META-ANALYSES WITH SPECIFIC
ASSESSMENT OF FETAL OUTCOME
V. Di Martino1 , L. Sentilhes2 , H.M. Reyes3 , A. Glantz4 ,
J. Kondrackiene5 , T. Binder6 , P.L. Nicastri7 , A. Locatelli8 , A. Floreani9 ,
I. Hernandez3 , Y. Bacq10 . 1 Service d’Hépatologie, Université de
Franche Comté, CHU Jean Minjoz, Besançon, 2 Service de GynécologieObstétrique, Angers, France; 3 Department of Experimental Medicine,
Universidad del Chile, Santiago, Chile; 4 Department of Obstetrics
and Gynecology, Sahlgrenska University Hospital, Goteborg, Sweden;
5
Department of Gastroenterology, Kaunas University of Medicine,
Konas, Lithuania; 6 Department of Obstetrics and Gynecology,
Medical School Charles Univ, Prague, Czech Republic; 7 Divisione
di Ostetrica e Ginecologia, Universita di Bari, Bari, 8 Divisione di
Ostetrica e Ginecologia, ISBM San Gerardo, Monza, 9 Department
of Gastroenterology, Universita di Padova, Padova, Italy; 10 Service
d’Hépato-Gastroenterologie, CHU de Tours, Tours, France
E-mail: vdimartino@chu-besancon.fr
ICP is characterized by pruritus associated with elevated serum bile
acid and serum ALT levels, and may increase the risk of prematurity
and intrauterine fetal death (IUFD). UDCA is the best medical
treatment for ICP but its role for preventing adverse fetal outcome
remains to be demonstrated. To address this point, we performed a
meta-analysis of randomized clinical trials (RCTs) comparing UDCA
to control treatments (CT) or placebo.
Methods: A compilation of the 9 RCTs (427 patients)
comparing UDCA (n = 207) to CT (n = 227 including 70 placebo,
36 dexamethasone, 65 SAM, 42 cholestyramin) reported on
the litterature have been achieved. 8 endpoints were studied:
(1) improvement of pruritus, (2) normalization of ALT within
14 to 21 days of treatment, (3) >50% decrease of total bile
acids (TBA), (4) total prematurity (TP: spontaneous or induced
delivery
891
PIVOT ROLE OF PAI 1 4G4G IN NON-CIRRHOTIC PORTAL VEIN
THROMBOSIS AND BUDD-CHIARI SYNDROME
M. D’Amico1 , M. Niceta2 , P. Sammarco2 , R. Virdone3 , E. Sinagra1 .
1
Gastroenterology Unit, V. Cervello Hospital, Palermo, Italy; 2 Genetics,
V. Cervello Hospital, Palermo, Italy; 3 Internal Medicine, V. Cervello
Hospital, Palermo, Italy, Palermo, Italy
E-mail: mario.dami@libero.it
Background and Aim: Thrombophilic genetic factors (TGFs) have
been shown to be a risk factor for deep venous thrombosis in
different districts. We showed recently that PAI1 4G4G and MTHFR
C677 TT were significantly more frequent both in hepatocellular
carcinoma (HCC) and portal vein thrombosis (PVT) in patients with
liver cirrhosis. The aim of our study was to evaluate PAI1 4G4G,
MTHFR C677 TT, V Leiden Q506, and prothrombin G20210A, as risk
factors for PVT or Budd-Chiari Syndrome (BCS) in patients without
liver cirrhosis or HCC.
Materials and methods: 53 patients with PVT of which 20 with
chronic myeloproliferative diseases (CMPD), 32 BCS of which 17
with CMPD, 96 patients with CMPD without PVT or BCS and 94
PLT donors healthy controls (HC) were consecutively enrolled. The
TGFs studied were analysed in relation to the presence of PVT or
BCS. After univariate analysis, we selected each significant TGF as
independent variable, to perform multivariate logistic regression
analysis using PVT, BCS and CMPD as dependent variable anyone of
which significantly related to one or more TGFs.
Results: We found that PAI 1 4G4G homozygosis and the presence
of more than one TGF were significantly (p < 0.005) more frequent in
patients with PVT and BCS vs HC. MTHFR C677 TT homozygosis was
significant different (p < 0.005) in PVT group vs HC and V Leiden
Q506 was significant (p < 0.005) in BCS vs HC. The synthesis of
3 logistic regression analysis for any disease studied showed the
significant (p < 0.05) value of: PAI1 4G4G in PVT, BCS and CMPD,
MTHFR 677TT in PVT and V Leiden Q506 in BCS.
Conclusion: Our results show for the first time that PAI1 4G4G
plays a significant role in PVT and BCS. The role of MTHFR 677TT
was confirmed in PVT even without chronic liver diseases. We
hypothesize that the significant relation of PAI1 4G4G with CMPD
may indicate a potential pathogenetic role of this factor through
microvascular thrombosis and fibrogenesis; this relation could also
be an explanation of frequent thrombotic events in CMPD.
892
URSODEOXYCHOLIC ACID (UDCA) IN THE TREATMENT
OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP):
A SYSTEMATIC REVIEW AND META-ANALYSES WITH SPECIFIC
ASSESSMENT OF FETAL OUTCOME
V. Di Martino1 , L. Sentilhes2 , H.M. Reyes3 , A. Glantz4 ,
J. Kondrackiene5 , T. Binder6 , P.L. Nicastri7 , A. Locatelli8 , A. Floreani9 ,
I. Hernandez3 , Y. Bacq10 . 1 Service d’Hépatologie, Université de
Franche Comté, CHU Jean Minjoz, Besançon, 2 Service de GynécologieObstétrique, Angers, France; 3 Department of Experimental Medicine,
Universidad del Chile, Santiago, Chile; 4 Department of Obstetrics
and Gynecology, Sahlgrenska University Hospital, Goteborg, Sweden;
5
Department of Gastroenterology, Kaunas University of Medicine,
Konas, Lithuania; 6 Department of Obstetrics and Gynecology,
Medical School Charles Univ, Prague, Czech Republic; 7 Divisione
di Ostetrica e Ginecologia, Universita di Bari, Bari, 8 Divisione di
Ostetrica e Ginecologia, ISBM San Gerardo, Monza, 9 Department
of Gastroenterology, Universita di Padova, Padova, Italy; 10 Service
d’Hépato-Gastroenterologie, CHU de Tours, Tours, France
E-mail: vdimartino@chu-besancon.fr
ICP is characterized by pruritus associated with elevated serum bile
acid and serum ALT levels, and may increase the risk of prematurity
and intrauterine fetal death (IUFD). UDCA is the best medical
treatment for ICP but its role for preventing adverse fetal outcome
remains to be demonstrated. To address this point, we performed a
meta-analysis of randomized clinical trials (RCTs) comparing UDCA
to control treatments (CT) or placebo.
Methods: A compilation of the 9 RCTs (427 patients)
comparing UDCA (n = 207) to CT (n = 227 including 70 placebo,
36 dexamethasone, 65 SAM, 42 cholestyramin) reported on
the litterature have been achieved. 8 endpoints were studied:
(1) improvement of pruritus, (2) normalization of ALT within
14 to 21 days of treatment, (3) >50% decrease of total bile
acids (TBA), (4) total prematurity (TP: spontaneous or induced
delivery