Hepatitis B vaccination and immunotherapies: an update

Neuroendocrine Dysregulation in Irritable Bowel Syndrome Patients: A Pilot Study

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is a multifactorial disorder, involving dysregulation of brain-gut axis. Our aim was to evaluate the neuroendocrine activity in IBS. METHODS: Thirty IBS and 30 healthy volunteers were enrolled. Psychological symptoms were evaluated by questionnaires. Urinary 5-hydroxyindoleacetic acid, plasma serotonin (5-hydroxytryptamine, 5-HT), endothelin, and neuropeptide Y (NPY), and plasma and urinary cortisol levels were evaluated. Fourteen IBS subjects underwent microneurography to obtain multiunit recordings of efferent postganglionic muscle sympathetic nerve activity (MSNA). RESULTS: Prevalent psychological symptoms in IBS were maladjustment (60%), trait (40%) and state (17%) anxiety, obsessive compulsive-disorders (23%), and depressive symptoms (23%). IBS showed increased NPY (31.9 [43.7] vs 14.8 [18.1] pmol/L, P = 0.006), 5-HT (214.9 [182.6] vs 141.0 [45.5] pg/mL, P = 0.010), and endothelin [1.1 [1.4] vs 2.1 [8.1] pg/mL, P = 0.054], compared to healthy volunteers. Moreover, plasma NPY, endothelin, cortisol and 5-HT, and urinary 5-hydroxyindoleacetic acid were associated with some psychological disorders (P ≤ 0.05). Despite a similar resting MSNA, after cold pressor test, IBS showed a blunted increase in MSNA burst frequency (+4.1 vs +7.8 bursts/min, P = 0.048; +30.1% vs +78.1%, P = 0.023). Baseline MSNA tended to be associated with urinary cortisol (ρ = 0.557, P = 0.059). Moreover, changes in heart rate after mental stress were associated with urinary cortisol (ρ = 0.682, P = 0.021) and changes in MSNA after mental stress were associated with plasma cortisol (ρ = 0.671, P = 0.024).” CONCLUSION: Higher concentrations of endothelin, NPY, and 5-HT were found to be associated with some psychological disorders in IBS patients together with an altered cardiovascular autonomic reactivity to acute stressors compared to healthy volunteers.

epidemiological changes of HCV and HBV infections in the era of new antiviral therapies and the anti-HBV vaccine

The World Health Organization [WHO] resolution adopted in 2010 recognized viral hepatitis as a global health problem. In April 2014, for the first time, the WHO produced guidelines for the screening, care and treatment of persons with hepatitis C infections. In May 2014, a follow-up resolution urged WHO Member States to develop and implement a national strategy for the prevention, diagnosis and treatment of viral hepatitis based on the local epidemiological context. Although blood donor screening, which began in the early 1990s, has reduced the spread of the virus in the population, the WHO estimates that 150 million people are chronically infected with hepatitis C virus [HCV] and are at an increased risk of developing liver cirrhosis and hepatocellular carcinoma. In addition, 3-4 million people are infected each year. HCV treatment is currently evolving rapidly, and several drugs are in various stages of development. With regard to the hepatitis B virus [HBV], in March 2015, the WHO published the first guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection, which were designed to complement the recent guidelines on HCV. Although the introduction of an effective vaccine against the hepatitis B virus has reduced the prevalence and health and economic impact of hepatitis in industrialized countries, the WHO estimates that more than 2 billion people are HBV-infected and 350 million people are chronic carriers