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In inflammatory diseases occurring outside the CNS, communication between the periphery and the brain via humoral and/or neural routes results in central neural changes and associated behavioral alterations. We have recently identified another immune-to-CNS communication pathway in the setting of organ-centered peripheral inflammation: namely, the entrance(More)
Signaling occurs between the liver and brain in cholestatic liver disease, giving rise to sickness behaviors such as fatigue. However, the signaling pathways involved are poorly defined. Circulating inflammatory mediator levels are increased in cholestasis, leading to speculation that they may be capable of activating circulating immune cells that(More)
Fatigue is an extremely common complaint among patients with chronic disease. However, because of the subjective nature of fatigue, and the lack of effective therapeutics with which to treat fatigue, this symptom is often ignored by clinicians, who instead focus on hard, objective disease end-points. Recently, the symptom of fatigue has received greater(More)
BACKGROUND & AIMS A sustained virologic response (SVR) to therapy for hepatitis C virus (HCV) infection is defined as the inability to detect HCV RNA 24 weeks after completion of treatment. Although small studies have reported that the SVR is durable and lasts for long periods, it has not been conclusively shown. METHODS The durability of treatment(More)
There are limited therapeutic options available for patients with autoimmune hepatitis in whom conventional treatment fails. A case series of five patients unresponsive to or unable to take azathioprine, 6-mercaptopurine or corticosteroids who were treated with mycophenolate mofetil (MMF) is reported. While on MMF, alanine aminotransferase normalized or(More)
BACKGROUND & AIMS Overproduction of nitric oxide by inducible nitric oxide synthase (iNOS) has been proposed as a pathogenic factor in colitis. The objective of this study was to examine the role of iNOS using iNOS-deficient mice in experimental colitis. METHODS Colitis was induced by intrarectal instillation of 3% acetic acid and assessed for(More)
OBJECTIVE To evaluate ribavirin, an oral antiviral agent, as therapy for chronic hepatitis C. DESIGN Randomized, double-blind, placebo-controlled study. SETTING Clinical Center of the National Institutes of Health, a tertiary referral research hospital. PATIENTS 29 patients with chronic hepatitis C who received oral ribavirin (600 mg twice daily) for(More)
Prior to the introduction of virally inactivated clotting factor concentrates, the majority of individuals with congenital bleeding disorders became infected with the hepatitis C virus. Although liver biopsy is valuable in prognosis and guiding antiviral therapy, there is a reluctance to perform biopsies in this population because of the risk of hemorrhage.(More)
The mechanisms that mediate the recruitment of Th1 and Th2 lymphocytes in vivo are poorly understood. We demonstrate that the mechanisms by which exogenously produced CD4(+) Th1 and Th2 cells roll and adhere in Con A-inflamed liver microcirculation differ dramatically: Th1 cells use alpha(4)beta(1)-integrin and Th2 cells use the vascular adhesion protein(More)
The effect of intestinal inflammation on norepinephrine release from the myenteric plexus in the Trichinella spiralis-infected rat was assessed. Longitudinal muscle-myenteric plexus preparations were preincubated with [3H]norepinephrine and release was evoked by electrical field stimulation and KCl administration. Preincubation of preparations with(More)