Digestive and Liver Disease - Volume 48 - Supplement 2

Abstracts of the 22

National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231

e75

secondary outcomes. Statistics: the meta-analyses were performed

by computing RD using random-effects model, if heterogeneity was

present. Egger’s-Hardbord regression test was pre-defined statistical

tests for publication bias assessment.

Results:

From 122 initially screened abstracts, 11 full text studies

were retrieved and a total of 12 treatment arms were analysed (1837

patients). Seven studies compared PEG vs. PEG, 1 sodium picosulfate

vs sodium picosulfate, 1 sodium picosulfate vs. PEG and 3 PEG vs.

sodium picosulfate. Overall, 88% (621/719) patients in the S group

vs. 86% (570/688) in the SD group had an adequate bowel cleansing.

Pooled RD was 2% [(C.l.95% -1.6 to 5.6), heterogeneity chi-squared=

13.88 (d.f.= 8) p = 0.085; I-squared (variation in RD attributable

to heterogeneity)= 42.4%, p = 0.280, Fig.1)]. In all but one studies,

split preparation was more effective than SD. Also, patients were

more compliant and had slightly less adverse events with the split

preparations but significant heterogeneity was present.

Conclusions:

Data shows that split preparations give a similar

adequate colon preparation compared with same-day preparations

and with a better compliance and less adverse events.

OC.01.9

OLGA–BASED STAGING AND DYSPLASIA RELEVANCE IN

50–70 YEARS OLD PATIENTS IN A PRIMARY OPEN ACCESS

ENDOSCOPY: PRELIMINARY RESULTS

Lenoci N.*, Imperiali G., Terreni N., Radaelli F., Mandelli G.,

Amato A., Paggi S., Rondonotti E., Andrealli A., Spinzi G.

Ospedale Valduce, Como, Italy

Background and aim:

Patients with gastric atrophy and intestinal

metaplasia may have a greater than 10-fold increased risk of gastric

cancer than the general population. A recent European consensus

statement suggested that biopsies of the proximal and distal

stomach are needed for adequate assessment of premalignant

gastric conditions, and that systems for histopathological staging

may be useful for identifying subgroups of patients with different

risks of progression to gastric cancer (1). Operative link on gastritis

assessment (OLGA) staging systemwas proposed for clinical purposes

to simplify the assessment of gastric cancer. If low-grade dysplasia

is detected a repeat surveillance gastroscopy with a topographic

mapping biopsy strategy should be performed within 1 year.

Material and methods:

Patients (age 50-70 years) undergoing upper

endoscopy fromSeptember 2013 to September 2015 in our open access

Endoscopy Service were enrolled. Biopsies from antrum (2), angulus

(1), and corpus (2) were obtained in patients with normal endoscopy.

Histological assessment according to OLGA and OLGIM staging was

performed by two experienced gastrointestinal pathologists, who

also evaluated Helicobacter pylori status. OLGA III/IV and pts with

dysplasia were considered eligible for surveillance of these lesions.

Results:

2026 upper endoscopy were performed (female 61.3%).

Biopsies were obtained from 1470 patients (F 1073 = 72,9% and M

397 = 27,1%). Eight patients presented with OLGA III stage (0,5%) and

5 with OLGA IV stage (0,34%). Furthermore, 2/8 pts with OLGA III

stage and 1/5 with OLGA IV stage had low grade dysplasia without

an endoscopic defined lesion; 1 patient with OLGA IV had low grade

dysplasia with an endoscopic lesion represented by erosions and

areas of scarring. Helicobacter pylori has been found in 5/13 pts with

OLGA III/IV stage. One patient undergoing the endoscopic follow-up

one year later presented the same OLGA IV stage without dysplasia.

Conclusions:

In our population with dyspepsia and epigastric pain

without significant lesions at upper endoscopy 0,84% of patients

presented with an OLGA III/IV stage. Four of these patients had low

grade dysplasia, one with a visible lesion. Follow-up of these lesions

and cost-effectiveness of this strategy are ongoing.

Reference:

1. Dinis-Ribeiro M, Areia M, de Vries AC, et al. Management of precancerous condi-

tions and lesions in the stomach (MAPS). Endoscopy 2012; 44: 74-94.

OC.02 IBD 1

OC.02.1

HIGH EXPRESSION OF DUBA, A REGULATOR OF T CELL

ACTIVATION, IN INFLAMMATORY BOWEL DISEASE

Dinallo V.*, Di Fusco D., Laudisi F., Marafini I., Monteleone I.,

Monteleone G.

Department of System Medicine, University of Rome Tor Vergata,

Rome, Italy

Background and aim:

The Dubiquitinase DUBA belongs to a family

of proteolytic enzymes whose function is to remove ubiquitin

from target proteins or polyubiquitin chains, resulting in altered

signaling or changes in protein stability. Control of ubiquitination is

involved in many important biological processes as well as in cancer

and inflammatory diseases. Since recent studies have shown the

involvement of DUBA in T cell activation, we aimed at investigating

the expression of DUBA in inflammatory bowel disease (IBD).

Material and methods:

DUBA was silenced in normal peripheral

blood mononuclear cell (PBMC) with a specific small interference

RNA (siRNA) and transfected T-cells were then activated with anti-

CD3/CD28 beads for further 24h. Pro-inflammatory cytokines (i.e. IL-

17A, INF-

) were evaluated by real-time PCR. DUBA expression was

evaluated in inflamed biopsy samples of patients with ulcerative

colitis (UC) and patients with Crohn’s disease (CD), as well as in

control biopsy samples and in the colons of mice with dextran-

sulfate sodium (DSS)-induced colitis by real-time PCR, western

blotting and immunohistochemistry.

Results:

In vitro silencing of DUBA with a specific siRNA diminished

production of IL-17A and INF-

from anti-CD3/CD28-activated

T cells, thus indicating a prominent role for DUBA in the positive

control of pathogenic cytokine responses. High DUBA was seen

in inflamed intestine of patients with UC and patients with CD as

compared to normal controls. Consistently, induction of DSS-colitis

in mice was accompanied by increased expression of DUBA at the

protein but not RNA level. Immunohistochemical analysis revealed

that both epithelial cells and lamina propria mononuclear cells

expressed elevated levels of DUBA during colitis.

Conclusions:

To the best of our knowledge this is the first to show a

deregulated expression of DUBA during colitis. The DUBA-mediated

positive control of effectors cytokine production suggests the

involvement of DUBA in the progression of IBD.

OC.02.2

HUMAN NEUTROPHIL ELASTASE CONTRIBUTES TO LOSS OF

FUNCTION OF INFLIXIMAB IN ULCERATIVE COLITIS

Giuffrida P.*

, Kok K.

, Curciarello R.

, Vanoli A.

, Mazza G.

Biancheri P.

, Pasini A.

, Pinzani M.

, Corazza G.R.

, Macdonald T.T.

Di Sabatino A.

First Department of Internal Medicine, San Matteo Hospital,

University of Pavia, Pavia, Italy,

Centre for Immunobiology, Blizard

Institute, Barts and the London School of Medicine and Dentistry,

London, United Kingdom,

Department of Molecular Medicine, San

Matteo Hospital, University of Pavia, Pavia, Italy,

UCL, Institute for

Liver and Digestive Health, University College London, London, United

Kingdom

Background and aim:

Up to a third of patients with ulcerative colitis

(UC) are primary non-responders to anti-tumor necrosis factor-

alpha agents, which act in the UC protease-rich inflamed mucosa.

Human neutrophil elastase (HNE) is a protease highly expressed

in UC, whose main target in extracellular matrix is elastin, but

the balance between HNE and its inhibitor elafin remains unclear.

Our aims were to investigate the elastinolytic activity in UC, and