Papers by Costantino Sgamato
World Journal of Gastroenterology
Digestive Diseases and Sciences, 2020
His clinical and research interests include chronic liver diseases and hepatocellular carcinoma d... more His clinical and research interests include chronic liver diseases and hepatocellular carcinoma diagnosis and treatment. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
To the Editor: We thank Drs. Celsa and Cammà for their insightful editorial1 on our article on th... more To the Editor: We thank Drs. Celsa and Cammà for their insightful editorial1 on our article on the impact of different proton pump inhibitors (PPIs) on cytochrome p450 (CYP-450) activity assessed by 13C-aminopyrine breath test in patients with cirrhosis.2 The authors recognise that the results are novel and improve the understanding of drug safety in patients with cirrhosis, but they make some points deserving further discussion. First, the authors emphasise that our results cannot be easily generalised to patients with Child-Pugh scores B and C cirrhosis. This is a critical matter, since patients with advanced cirrhosis usually have serious complications and require multiple drugs, thus being at higher risk of drug-to-drug interactions (DDI). In these patients, in addition to the impaired metabolic capacity of the liver, portosystemic shunting, reduction of drug-binding proteins, abnormal drug volume of distribution, altered pharmacodynamics and associated renal failure can impact ...
Alimentary Pharmacology & Therapeutics, 2020
Chronic use of proton pump inhibitors (PPIs) in patients with impaired liver function may worsen ... more Chronic use of proton pump inhibitors (PPIs) in patients with impaired liver function may worsen cytochrome P450 (CYP450) activity, predisposing them to clinically relevant drug–drug interactions. The 13C‐aminopyrine breath test (13C‐ABT) is a non‐invasive tool to study CYP450‐dependent liver function.
Frontiers in Cell and Developmental Biology
Hepatic encephalopathy (HE) is a severe complication of advanced liver disease and acute liver fa... more Hepatic encephalopathy (HE) is a severe complication of advanced liver disease and acute liver failure. The clinical spectrum ranges from minor cognitive dysfunctions to lethargy, depressed consciousness, and coma and significantly impact the quality of life, morbidity, and mortality of the patients. It is commonly accepted that the gut milieu is essential for the development of HE; however, despite intensive research efforts, the pathogenesis of HE is still not fully elucidated. As our knowledge of gut microbiota moves from the pioneering era of culture-dependent studies, the connection between microbes, inflammation, and metabolic pathways in the pathogenesis of HE is becoming increasingly clear, providing exciting therapeutic perspectives. This review will critically examine the latest research findings on the role of gut microbes in the pathophysiological pathways underlying HE. Moreover, currently available therapeutic options and novel treatment strategies are discussed.
Digestive and Liver Disease
Lactose intolerance (LI) is characterized by diarrhea, abdominal pain, or bloating occurring afte... more Lactose intolerance (LI) is characterized by diarrhea, abdominal pain, or bloating occurring after lactose consumption in patients with lactose malabsorption. The National Institute of Health (NIH) proposed a double-blind placebo testing to identify LI individuals correctly. However, until now, no study used this approach in a real-life setting. We aimed to assess double-blind placebo challenge accuracy in diagnosing LI in patients with self-reported symptoms of LI. 148 patients with self-reported LI were consecutively enrolled and blindly underwent hydrogen breath test (HBT) after 25 g lactose or 1 g glucose (placebo) load. One week later, the subjects were challenged with the alternative substrate. Each subject completed a validated questionnaire, including five symptoms (diarrhea, abdominal pain, vomiting, bowel sounds, and bloating) scored on a 10-cm visual analog scale. Home questionnaire (HQ) referred to symptoms associated with the consumption of dairy products at home, while...
Digestive Diseases
Background: Multiple lines of evidence now support the notion that gut microbiota can contribute ... more Background: Multiple lines of evidence now support the notion that gut microbiota can contribute to digestive and extra-digestive diseases. The emergence of these observations enabled to postulate a bacteria-centric paradigm to rethink the treatment of many diseases. The goal of therapy should not be to eradicate the flora but to modify it in a way that leads to symptomatic improvement; thus, the interest in the use of probiotics to modulate microbiota composition has increased worldwide in both community and healthcare settings. Summary: The results of published studies are conflicting for most probiotic strains and formulations, and clinicians and consumers need a better understanding of probiotic risks and benefits. Currently, clear guidelines on when to use probiotics and the most effective probiotic for different gastrointestinal conditions are still lacking. Here, we reviewed the studies on the use of probiotics in some diseases of relevant interest to gastroenterologists, suc...
Digestive Diseases and Sciences
Hepatitis-associated aplastic anemia is a well-recognized clinical syndrome in which marrow failu... more Hepatitis-associated aplastic anemia is a well-recognized clinical syndrome in which marrow failure follows the development of hepatitis. Although aplastic anemia is intimately related to paroxysmal nocturnal hemoglobinuria, until now, no cases of PNH-associated hepatitis have been described. We report a case of recurrent acute hepatitis preceding the clinical onset of PNH. Treatment of PNH with the complement inhibitor eculizumab (Soliris®) prevented both recurrences of episodes of intravascular hemolysis and liver enzyme alteration. This is the first known published case of PNH-associated hepatitis.
Endoscopy International Open
Background and study aims The over-the-scope clip (OTSC) is a novel tool used to improve the main... more Background and study aims The over-the-scope clip (OTSC) is a novel tool used to improve the maintenance of hemostasis for non-variceal upper gastrointestinal bleeding (NVUGIB); however, studies on the comparison with “conventional” techniques are lacking. In this study, we aimed to compare first-line endoscopic hemostasis achieved using conventional techniques with that achieved using OTSC placement for NVUGIB. Patients and methods From January 2007 to March 2018, 793 consecutive patients underwent upper endoscopy with the hemostasis procedure. Among them, 327 patients were eligible for inclusion (112 patients had OTSC placement and 215 underwent conventional hemostasis). After propensity score matching and adjustment for confounding factors, 84 patients were stratified into the “conventional” group and 84 into the OTSC group. Patient characteristics and outcomes (rebleeding rate, mortality rate within 30 days, and adverse events) were compared between the two groups. Results In th...
Endoscopy
Video 1 A large submucosal tumor in the sigmoid colon that was resected by underwater endoscopic ... more Video 1 A large submucosal tumor in the sigmoid colon that was resected by underwater endoscopic submucosal resection. ▶ Fig. 1 Computed tomography scan image showing a mass located in the left colon. Caruso Angelo et al. Underwater ESD of a giant colonic lipoma … Endoscopy This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.
Digestive and Liver Disease, 2015
Proton pump inhibitors may foster intestinal dysbiosis and related bowel symptoms. To evaluate th... more Proton pump inhibitors may foster intestinal dysbiosis and related bowel symptoms. To evaluate the effect of Lactobacillus paracasei F19 on bowel symptom onset in patients on long-term proton pump inhibitors. In this randomized, double-blind, placebo-controlled study, patients with typical gastroesophageal reflux disease symptoms receiving pantoprazole 40mg/d for six months were randomly assigned to receive: (A) Lactobacillus paracasei F19 bid for three days/week for six months; (B) placebo bid for three days/week for six months; (C) Lactobacillus paracasei F19 bid for three days/week for three months and placebo bid for three days/week for the following three months; (D) placebo bid for three days/week for three months and Lactobacillus paracasei F19 bid for three days/week for the following three months. Bloating, flatulence, abdominal pain and bowel habit were assessed monthly. 100/312 patients were enrolled. In the parallel groups, the treatment-by-time interaction affected bloating (p=0.015), while Lactobacillus paracasei F19 treatment alone affected flatulence (p=0.011). Moreover, the treatment-by-time interaction significantly affected the mean score of bloating (p=0.01) and flatulence (p<0.0001), the mean stool form (p=0.03) and mean stool frequency/week (p=0.016). Analysis of the cross-over groups, limited to the first three months because of carry-over effect, confirmed these results. Lactobacillus paracasei F19 supplementation prevents bowel symptom onset in patients on long-term proton pump inhibitors.
BMC Gastroenterology
Background: The evidence on the role of gut microbiota in post-infectious irritable bowel syndrom... more Background: The evidence on the role of gut microbiota in post-infectious irritable bowel syndrome (PI-IBS) is convincing. Lactobacillus spp. positively affect IBS symptoms, although the mechanisms through which probiotics exert their beneficial effects are largely unknown. The aim of the study is to evaluate the role of Lactobacillus casei DG (LC-DG) and its postbiotic (PB) in modulating the inflammatory/immune-response in PI-IBS in an ex-vivo organ culture model. Methods: Ex vivo cultures of ileal and colonic mucosa from 10 PI-IBS, diarrhea predominant subtype (D) patients, and 10 healthy controls (HC) were treated with LPS, LC-DG and PB. Interleukin (IL)-1α, IL-6, IL-8 and IL-10 mRNA levels were assessed by real-time PCR and Toll like receptor 4 (TLR-4) protein expression by Western blotting. Results: At baseline, IL-1α, IL-6 and IL-8 mRNA levels as well as TLR-4 protein expression were significantly higher while IL-10 mRNA levels were lower in PI-IBS D than in HC in both ileum and colon. LC-DG and PB significantly reduced the mRNA levels of pro-inflammatory cytokines and TLR-4 while increased that of IL-10 after LPS stimulation. The protective effect was more pronounced for PB than LC-DG treatment. Conclusion: LC-DG and its PB attenuate the inflammatory mucosal response in an ex-vivo organ culture model of PI-IBS D.
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Papers by Costantino Sgamato