Browsing by Author "Arab Verdugo, Juan Pablo"

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    A Precision Medicine Guided Approach to the Utilization of Biomarkers in MASLD
    (2024) Thakral, Nimish; Desalegn, Hailemichael; Diaz Piga, Luis Antonio; Cabrera, Daniel; Loomba, Rohit; Arrese Jiménez, Marco Antonio; Arab Verdugo, Juan Pablo
    The new nomenclature of metabolic dysfunction-associated steatotic liver disease (MASLD) emphasizes a positive diagnosis based on cardiometabolic risk factors. This definition is not only less stigmatizing but also allows for subclassification and stratification, thereby addressing the heterogeneity of what was historically referred to as nonalcoholic fatty liver disease. The heterogeneity within this spectrum is influenced by several factors which include but are not limited to demographic/dietary factors, the amount of alcohol use and drinking patterns, metabolic status, gut microbiome, genetic predisposition together with epigenetic factors. The net effect of this dynamic and intricate system-level interaction is reflected in the phenotypic presentation of MASLD. Therefore, the application of precision medicine in this scenario aims at complex phenotyping with consequent individual risk prediction, development of individualized preventive strategies, and improvements in the clinical trial designs. In this review, we aim to highlight the importance of precision medicine approaches in MASLD, including the use of novel biomarkers of disease, and its subsequent utilization in future study designs.
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    Achieving protection against HBV in HIV patients: Finding the best strategy
    (2016) Vargas J.; Arab Verdugo, Juan Pablo; Jensen D.; Fuster F.
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    Actualizaciones en el manejo general de pacientes postrasplante hepático y de sus complicaciones más frecuentes
    (2024) Díaz Piga, Luis Antonio; Villalón Friedrich, Alejandro Andrés; Ochoa, Gabriela; García Castillo, Sergio Adrián Nicolas; Severino Cuevas, Nicolás Felipe; Ayares Campos, Gustavo Ignacio; Idalsoaga Ferrer, Francisco Javier; Dib Marambio, Martín Javier; Briceño Valenzuela, Eduardo Andrés; Viñuela Fawaz, Eduardo Andrés; Martínez Castillo, Jorge Arturo; Jarufe Cassis, Nicolás Patricio; Rabagliati Borie, Ricardo Miguel; Meneses Quiroz, Luis Andrés; Muñoz Schuffenegger, Pablo; Vargas Domínguez, José Ignacio; Espino Espino, Alberto Antonio; Vera Alarcón, María Magdalena; Benítez Gajardo, Carlos Esteban; Wolff Rojas, Rodrigo Mauricio; Norero Muñoz, Blanca Gabriela; Barrera Álvarez, Francisco Benjamín; Soza Ried, Alejandro; Arrese Jiménez, Marco Antonio; Arab Verdugo, Juan Pablo
    Liver transplantation (LT) is a cost-effective therapy for advanced liver disease. Although LT significantly improves long-term survival, it requires strict control of immunosuppressants and their potential complications. Several available immunosuppressive drugs include glucocorticoids, calcineurin inhibitors, mycophenolate, mTOR inhibitors, and anti-CD25 antibodies. These drugs act particularly in T lymphocytes, depleting them, deviating their traffic, or blocking their response pathways. The main complications after LT include renal failure and infectious, immunological, biliary, vascular adverse events, metabolic, cardiovascular, and neoplastic diseases, especially during the first months. Bacteria, viruses, and fungi can cause infections in these patients. Prophylaxis against Herpes simplex virus, Varicella zoster virus, Cytomegalovirus, Pneumocystis jirovecii, Candida spp., and Aspergillus spp. should be considered according to the presence of risk factors. Among immunological complications, acute cellular rejection is common (30% of LT) but usually responds to immunosuppressive escalation. Also, chronic rejection appears in 3-17% of LT, but only half of the recipients respond to increased immunosuppressants. Appropriate treatment of the underlying etiology is essential, especially in autoimmune diseases, hepatitis B and C virus infection. Lifestyle changes must be encouraged in all patients, and alcohol consumption avoided (especially in alcohol use disorder). Due to the increased risk of cancer, neoplasms must be actively monitored, as well as osteoporosis and other metabolic disorders such as diabetes and cardiovascular disease.
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    Advancements in MELD Score and Its Impact on Hepatology
    (Thieme Medical Publishers, Inc., 2024) Hudson, David; Valentin Cortez, Francisco Javier; Hurtado Díaz de León, Ivonne; Malhi, Gurpreet; Rivas, Angélica; Afzaal, Tamoor; Rad, Mahsa Rahmany; Díaz Piga, Luis Antonio; Khan, Mohammad Qasim; Arab Verdugo, Juan Pablo
    There continues to be an ongoing need for fair and equitable organ allocation. The Model for End-Stage Liver Disease (MELD) score has evolved as a calculated framework to evaluate and allocate patients for liver transplantation objectively. The original MELD score has undergone multiple modifications as it is continuously scrutinized for its accuracy in objectively representing the clinical context of patients with liver disease. Several refinements and iterations of the score have been developed, including the widely accepted MELD-Na score. In addition, the most recent updated iteration, MELD 3.0, has been created. The MELD 3.0 calculator incorporates new variables such as patient sex and serum albumin levels and assigns new weights for serum sodium, bilirubin, international normalized ratio, and creatinine levels. It is anticipated that the use of MELD 3.0 scores will reduce overall waitlist mortality and enhance access for female liver transplant candidates. However, despite the emergence of the MELD score as one of the most objective measures for fair organ allocation, various countries and healthcare systems employ alternative methods for stratification and organ allocation. This review article will highlight the origins of the MELD score, its iterations, the current MELD 3.0, and future directions for managing liver transplantation organ allocation.
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    Alcohol-related liver disease : Clinical practice guidelines by the Latin American Association for the Study of the Liver (ALEH)
    (2019) Arab Verdugo, Juan Pablo; Roblero, J.P.; Altamirano, J.; Bessone, F.; Araujo, R.C.; Higuera-De la Tijera, F.; Restrepo, J.C.; Torre, A.; Urzua, A.; Simonetto, D.A.; Abraldes, J.G.; Mendez-Sanchez, N.; Contreras, F.; Lucey, M.R.; Shah, V.H.; Cortez-Pinto, H.; Bataller, R.
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    Alcohol-Related Liver Disease in Latin America: Local Solutions for a Global Problem
    (John Wiley and Sons Inc, 2020) Díaz Piga, Luis Antonio; Roblero Cum, Juan Pablo; Bataller, Ramon; Arab Verdugo, Juan Pablo
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    An Open-Label, Dose-Escalation Study to Assess the Safety and Efficacy of IL-22 Agonist F-652 in Patients With Alcohol-associated Hepatitis
    (2020) Arab Verdugo, Juan Pablo; Sehrawat, T. S.; Simonetto, D. A.; Verma, V. K.; Feng, D. C.; Tang, T.; Dreyer, K.; Yan, X. Q.; Daley, W. L.; Ibacache Figueroa, Mauricio Enrique; Sanyal, A.; Chalasani, N.; Radaeva, S.; Yang, L.; Vargas, H.; Gao, B.; Gores, G. J.; Malhi, H.; Kamath, P. S.; Shah, V. H.
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    Andrographolide Ameliorates Inflammation and Fibrogenesis and Attenuates Inflammasome Activation in Experimental Non-Alcoholic Steatohepatitis
    (2017) Cabrera, Daniel; Wree, Alexander; Povero, Davide; Solís, Nancy; Hernández, Alejandra; Pizarro Rojas, Margarita Alicia; Moshage, Han; Torres Montes, Paula Javiera; Feldstein, Ariel E.; Cabello Verrugio, Claudio Alejandro; Brandan, Enrique; Barrera Martínez, Francisco Javier; Arab Verdugo, Juan Pablo; Arrese Jiménez, Marco
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    La asociación de un probiótico al régimen de erradicación de Helicobacter pylori no aumenta la eficacia ni disminuye los efectos adversos del tratamiento
    (2015) Zamora Helo, Maximiliano; Herrera A., Sofía; Yañez C., Gonzalo; Arab Verdugo, Juan Pablo; Riquelme Pérez, Arnoldo; Zamora H., Maximiliano; Herrera A., Sofía; Yañez C., Gonzalo; Arab Verdugo, Juan Pablo; Riquelme Pérez, Arnoldo
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    Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes
    (Elsevier B.V., 2023) Diaz Piga, Luis Antonio; Fuentes, López Eduardo; Idalsoaga Ferrer, Francisco Javier; Ayares Campos, Gustavo Ignacio; Corsi Sotelo, Oscar Felipe; Arnold Alvarez, Jorge Ignacio; Cannistra Cadiz, Macarena Rossella; Vio Quiroz, Danae Fernanda; Marquez Lomas, Andrea; Ramirez Cadiz, Carolina Andrea; Medel Salas, María Paz; Hernández Tejero, María; Ferreccio Readi, Fresia Catterina; Lazo Bravo, Mariana Carolina; Roblero Cum, Juan Pablo; Cotter, Thomas G.; Kulkarni ,Anand V.; Kim, Won; Brahmania, Mayur; Louvet, Alexandre; Tapper, Elliot B.; Dunn, Winston; Simonetto, Douglas; Shah, Vijay H.; Kamath, Patrick S.; Lazarus, Jeffrey V.; Singal, Ashwabi K.; Bataller, Ramón; Arrese Jimenez, Marco Antonio; Arab Verdugo, Juan Pablo
    © 2023 The Author(s)Background & Aims: The long-term impact of alcohol-related public health policies (PHPs) on disease burden is unclear. We aimed to assess the association between alcohol-related PHPs and alcohol-related health consequences. Methods: We conducted an ecological multi-national study including 169 countries. We collected data on alcohol-related PHPs from the WHO Global Information System of Alcohol and Health 2010. Data on alcohol-related health consequences between 2010–2019 were obtained from the Global Burden of Disease database. We classified PHPs into five items, including criteria for low, moderate, and strong PHP establishment. We estimated an alcohol preparedness index (API) using multiple correspondence analysis (0 lowest and 100 highest establishment). We estimated an incidence rate ratio (IRR) for outcomes according to API using adjusted multilevel generalized linear models with a Poisson family distribution. Results: The median API in the 169 countries was 54 [IQR 34.9–76.8]. The API was inversely associated with alcohol use disorder (AUD) prevalence (IRR 0.13; 95% CI 0.03–0.60; p = 0.010), alcohol-associated liver disease (ALD) mortality (IRR 0.14; 95% CI 0.03–0.79; p = 0.025), mortality due to neoplasms (IRR 0.09; 95% CI 0.02–0.40; p = 0.002), alcohol-attributable hepatocellular carcinoma (HCC) (IRR 0.13; 95% CI 0.02–0.65; p = 0.014), and cardiovascular diseases (IRR 0.09; 95% CI 0.02–0.41; p = 0.002). The highest associations were observed in the Americas, Africa, and Europe. These associations became stronger over time, and AUD prevalence was significantly lower after 2 years, while ALD mortality and alcohol-attributable HCC incidence decreased after 4 and 8 years from baseline API assessment, respectively (p <0.05). Conclusions: The API is a valuable instrument to quantify the robustness of alcohol-related PHP establishment. Lower AUD prevalence and lower mortality related to ALD, neoplasms, alcohol-attributable HCC, and cardiovascular diseases were observed in countries with a higher API. Our results encourage the development and strengthening of alcohol-related policies worldwide. Impact and implications: We first developed an alcohol preparedness index, an instrument to assess the existence of alcohol-related public policies for each country. We then evaluated the long-term association of the country's alcohol preparedness index in 2010 with the burden of chronic liver disease, hepatocellular carcinoma, other neoplasms, and cardiovascular disease. The strengthening of alcohol-related public health policies could impact long-term mortality rates from cardiovascular disease, neoplasms, and liver disease. These conditions are the main contributors to the global burden of disease related to alcohol use. Over time, this association has not only persisted but also grown stronger. Our results expand the preliminary evidence regarding the importance of public health policies in controlling alcohol-related health consequences.
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    Aumento aislado y sostenido de aspartato aminotransferasa por presencia de macroenzimas. Caso clínico
    (2016) Bustamante, Verónica; Arab Verdugo, Juan Pablo; Terc, Florencia; Poggi, Helena; Goycoolea, Manuela; Arrese Jiménez, Marco; Quiroga, Teresita; Benítez, Carlos
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    Baveno VI and Expanded Baveno VI criteria successfully predicts the absence of high-risk gastro-oesophageal varices in a Chilean cohort
    (2020) Gaete Celis, María Isabel; Díaz Piga, Luis Antonio; Arenas Fajardo, Cristian Alexis; Gonzalez, K.; Cattaneo, M.; Soza, Alejandro; Arrese, Marco; Barrera Martínez, Francisco José; Arab Verdugo, Juan Pablo; Benítez, Carlos; Fuster, F.; Henriquez, R.
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    Beneficial effects of mineralocorticoid receptor blockade in experimental non-alcoholic steatohepatitis
    (2015) Pizarro, M.; Solís, Nancy; Quintero, P.; Barrera Martínez, Francisco José; Cabrera, D.; Rojas-de Santiago, P.; Arab Verdugo, Juan Pablo; Padilla, O.; Roa Strauch, Juan Carlos Enrique; Moshage, H.; Wree, A.; Inzaugarat, E.; Feldstein, A.; Fardella B., Carlos; Baudrand Biggs, René; Riquelme, A.; Arrese Jiménez, Marco
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    Bile acid supplementation improves established liver steatosis in obese mice independently of glucagon-like peptide-1 secretion
    (2014) Quintero, Pablo; Pizarro Rojas, Margarita Alicia; Solís, Nancy; Arab Verdugo, Juan Pablo; Padilla Pérez, Oslando; Riquelme Pérez, Arnoldo; Arrese Jiménez, Marco
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    Bile acids and nonalcoholic fatty liver disease : molecular insights and therapeutic perspectives
    (2017) Arab Verdugo, Juan Pablo; Karpen, S.; Dawson P.; Arrese Jiménez, Marco; Trauner, M.
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    Bile acids and portal hypertension
    (2017) Arab Verdugo, Juan Pablo; Barrera Martínez, Francisco José; Arrese Jiménez, Marco
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    Bile Acids in Cholestasis and its Treatment
    (2017) Arab Verdugo, Juan Pablo; Cabrera, D.; Arrese Jiménez, Marco
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    Black hairy tongue during interferon therapy for hepatitis C
    (2015) Arab Verdugo, Juan Pablo; Vargas, J.; Morales, C.; Arrese Jiménez, Marco; Arab Verdugo, Juan Pablo; Vargas, J.; Morales, C.; Arrese Jiménez, Marco
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    Burnout en médicos residentes de especialidades y subespecialidades: estudio de prevalencia y variables asociadas en un centro universitario
    (2017) Díaz Piga, Luis Antonio; Arab Verdugo, Juan Pablo; Núñez Palma, Carolina Verónica; Robles García, Camila; Bitrán Carreño, Marcela; Nitsche Royo, María Pía; Riquelme Pérez, Arnoldo; González Tugas, Matías; Hoyl Moreno, María Trinidad; Lopetegui Lazo, Marcelo; Torres Lisboa, Patricio; Véliz Lagos, Daniela
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    CD4/CD8 ratio as a predictor of the response to HBV vaccination in HIV-positive patients : a prospective cohort study
    (2016) Acuña, P.; Peirano, F.; Fuster, F.; Arab Verdugo, Juan Pablo; Martínez, F.; Sabrina, Soto; Ahumada, Rodrigo; Jensen, Werner; Fuster, F.; Vargas Domínguez, José Ignacio; Jensen, D.; Sarmiento, V.