Consequently, we suggest that intersexual selection through female mate choice is unlikely to be a major factor driving the evolution of male red deer harsh roars. “
“Departamento de Biologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil In certain lineages of tetrapods, latitude and climate relate to body size in agreement with Bergmann’s rule. Trends for squamates are ambiguous, even between selleck inhibitor genders within a species. Therefore, additional studies are

required before generalizations can be made, and attention is needed to the possibility that male and female experience distinct selective pressures and display different patterns. We examine body size in male and female Tropidurinae lizard species and test both Bergmann’s and Rensch’s rule, using phylogenetic comparative methods. We also analyze whether trends are better explained by latitude or climatic conditions. In Tropidurinae lizards, body size does not vary in accordance with Bergmann’s rule within the range of latitudes

studied. Therefore, within this range, tropidurines seem not to experience thermal constraints limiting activity time, and therefore growth and body size. Yet, female body size relates to rain selleck products patterns, expectedly linked to productivity, suggesting that this gender experiences a stronger tradeoff between energy allocated to growth and to reproduction. In Tropidurinae, males tend to be larger than females and sexual dimorphism is male biased, with an isometric relationship between both sexes that does not support Rensch’s rule. selleck compound “
“Unlike high-altitude Rhacophorus moltrechti breeding in spring and summer and middle-altitude populations breeding throughout

the year, one possible mechanism causing lowland populations to breed in winter may be that high summer temperatures at low altitudes are stressful for tadpoles and lowland populations so they breed in winter to avoid this stress. However, breeding in the winter, which is the dry season in Taiwan, causes high densities as the water bodies they breed in are smaller and more isolated. We tested whether high summer water temperatures impose a cost and high tadpole densities lead to a benefit in growth, development and survival of lowland tadpoles by rearing tadpoles at three temperatures (17 and 22°C are two typical winter water temperatures and 27°C is a representative summer water temperature) and four different densities (5, 10, 20 and 30 tadpoles per box). We found that tadpoles metamorphosed earlier and at smaller sizes at 22°C (the higher winter water temperature) than tadpoles raised at either 17 or 27°C. Tadpoles raised at 27°C exhibited a longer larval period and a smaller metamorphic size than those raised at 22°C.

Markov modeling suggested a benefit associated with receipt of LDLT VX-809 cost in patients with hepatocellular carcinoma (HCC)2, 3 compared with waiting for DDLT. Experience from A2ALL, however, demonstrated higher rates of posttransplant recurrence in liver transplant

candidates with HCC who underwent LDLT.4 Similarly, there is uncertainty regarding whether there is a survival benefit associated with receipt of LDLT among transplant candidates with MELD <15. Two recent large database analyses of the U.S. liver transplant population have suggested that a survival benefit is obtained by transplant candidates undergoing transplantation with MELD scores in excess of 155 or 126 in comparison to remaining on the waiting list. Analyses

from the retrospective cohort study reported by A2ALL suggested a survival benefit for transplant candidates enrolled in A2ALL with laboratory (nonexception) MELD scores less than 15, although the majority of those patients were actually transplanted Tyrosine Kinase Inhibitor Library chemical structure in the pre-MELD allocation era.1 To resolve some of the uncertainties delineated above, and better inform liver transplant candidates regarding transplant outcomes in the current allocation paradigm, we examined data from A2ALL for liver transplant candidates who entered into the study following the introduction of the MELD-based liver allocation system on February 28, 2002 through August 31, 2009. Outcomes for these patients who presented to A2ALL transplant centers with their first potential living donor during this period were analyzed in order to assess the potential benefit of receipt of LDLT based on transplant candidate MELD score and presence or absence of HCC. The study design, which examined patient outcomes from the time of first living donor evaluation, was created to allow clinicians to counsel transplant candidates and their donors when the opportunity for LDLT presented itself check details in the transplant clinic setting. A2ALL, adult to adult living donor

liver transplant study; DDLT, deceased donor liver transplant; DRI, donor risk index; HCC, hepatocellular carcinoma; LDLT, living donor liver transplant; MELD, model for endstage liver disease; SRTR, Scientific Registry for Transplant Recipients; TIPSS, transjugular intrahepatic portosystemic shunt. A primary objective of the A2ALL study has been to identify transplant candidates who accrue a survival benefit from adult LDLT. In order to encompass both pretransplant events and posttransplant survival, patient entry into the study occurred on the date that each potential LDLT candidate’s first potential living donor presented for initial donor history and physical examination at one of the nine A2ALL transplant centers as previously described.

[16] A sample size of 230 ex-IDUs would determine the prevalence of HCV infection with a confidence interval of 6.4% at a 95% confidence level. Statistical tests were selleck chemical performed using the Statistical Package for Social Science (SPSS version 20.0, Chicago, IL). Continuous variables were reported in mean (standard deviation [SD]) or median (interquartile range [IQR]) and compared between patients who attended and defaulted follow-ups using unpaired t-test and

Mann–Whitney U-test as appropriate. Categorical variables were compared using the chi-square test or Fisher exact text. A two-sided P value of < 0.05 was taken as statistically significant. From November 2009 to October 2012, we organized 10 education and screening sessions at four urban rehabilitation centers and served 234 subjects. Together, the four centers were actively serving around 400 ex-IDUs. The group size ranged from 8 to 40 subjects. Overall, www.selleckchem.com/products/NVP-AUY922.html 130 subjects tested positive for anti-HCV, with a prevalence of 56% (95% confidence

interval, 49–62%). The number needed to screen to detect one patient with positive anti-HCV was 1.8 (95% confidence interval, 1.6–2.0). One hundred eleven (85%) patients with HCV infection consented to the study and attended the first assessment session (Fig. 1). Most patients were middle-aged men with little education (Table 1). Ninety-seven (87%) patients reported that they did not know the diagnosis of HCV infection before attending the program. The majority of this cohort had genotype

1b and 6a HCV infection (Table 1). The mean HCV RNA was 5.2 (SD 2.3) log IU/mL, and 98 (88%) patients had detectable HCV RNA. One hundred nine (98%) patients had reliable liver stiffness measurements. Twenty-eight (26%) of them had liver stiffness above 7.9 kPa, a level suggestive of selleck inhibitor significant fibrosis or cirrhosis. Fifteen (14%) had liver stiffness above 11.9 kPa, a level suggestive of cirrhosis. At study entry, all patients had compensated liver disease. However, during a mean follow-up of 32 (SD 12, range 10–46) months, three patients developed HCC at 4, 17, and 18 months. They were treated with transarterial chemoembolization, radiofrequency ablation, and sorafenib, respectively. The patient on sorafenib died of liver failure 5 months after the diagnosis of HCC. In addition, one patient died of aortic dissection, one died of carcinoma of lung, and two were found cardiac arrest at home with no identified apparent cause. Of 111 patients who underwent liver assessment and were referred to the regional hospitals, 69 (62%) attended subsequent follow-up. Patients who attended follow-up were older, had higher education level, and more active disease as evidenced by higher alanine aminotransferase, HCV RNA, and liver stiffness (Table 1). Twenty-six (23%) patients received peginterferon and ribavirin treatment, of whom nine (35%) required dose adjustment, and six (23%) terminated treatment prematurely.

19, 20 Northern analysis was performed essentially as previously described.20 The RNAs were glyoxalated and then resolved using 1.7% agarose gels. The hybridization solution used was Ultrahyb Ultrasensitive Hybridization Buffer, containing 0.1 mg/mL of

sheared salmon sperm DNA (Applied Biosystems). The HDV RNAs were detected using 32P-labeled riboprobes, produced by in vitro transcription of either pTW108 or pTW107 plasmid linearized with HindIII. Plasmid Fulvestrant cell line pTW108 bears 1.1× unit-length HDV genome (G), whereas plasmid pTW107 contains 1.1× of the HDV antigenome (aG).20-22 Radioactivity was visualized using a biomolecular imager (Typhoon FLA 9000, GE Heathcare). Images were acquired and quantified using ImageQuant TL and prepared for publication using PowerPoint and Adobe Photoshop software. The procedure has been described in detail elsewhere.19 The primers used were: (1) forward primer, 312-GGACCCCTTCAGC GAACA-329; and (2) reverse primer, 393-CCTAGC ATCTCCTCCTATCGCTAT-360. The TaqMan probe was 332-AGGCGCTTCGAGCGGTAGGAGTAAGA-357.

The HDV numbering was according to Kuo et al.23 To assay G RNA, the above reverse primer was used in the reverse transcription (RT) reaction. To assay aG RNA, the above forward primer was used for the RT reaction. The copy numbers were quantified EPZ-6438 order using a 10-fold dilution series of either G or aG RNA standards (range: 20-200,000 GE of HDV). We deduce that 1 million HDV RNA molecules (G or aG) is equal to 1 pg of the corresponding HDV RNA standard. The 7500 Real Time PCR instrument (Applied Biosystems) was used for all qPCR assays according to the instructions of the manufacturer. The cccDNA-enriched fraction that is mostly free of cellular genomic DNA was isolated using previously described protocols24-26 and was further treated with RNase A (Roche), Hpa I (New England Biolabs), and Plasmid-Safe-ATP-dependent

DNase (Epicentre Technologies) to eliminate RNA, linear WHV DNA intermediates, double-stranded (ds) linear WHV genomic DNA, residual genomic cellular DNA, and certain forms of relaxed circular (rc) WHV DNA. The resulting DNA was subsequently treated with Mung Bean nuclease (New England Biolabs) to eliminate remaining relaxed circular DNA (rcDNA). The qPCR to quantify cccDNA assayed the dsDNA region unique for cccDNA. Forward primer, 1701-GGTCCGTGTT GCTTGGTCT-1719; reverse primer, 1977-GGACAT GGAACACAGGCAAAAACA-1954; this website and TaqMan probe, 1846-AATGGGAGGAGGGCAGCATTGATCCT-1871 were used. The numbering corresponds to the WHV7 sequence.27 qPCR was performed with the Applied Biosystems TaqMan Gene Expression Mastermix using each primer at a concentration of 600 nM and the TaqMan probe at a concentration of 250 nM. The reaction conditions were 10 minutes at 95°C, followed by 40 cycles of 15 seconds at 95°C, and 60 seconds at 60°C. To calculate cccDNA copy numbers, a 10-fold dilution series of NheI-linearized plasmid PUC-CMVWHV28 was used (range: 20-200,000 GE of WHV).

Accordingly, Peptide 17 price international guidelines recently published by the European Crohn’s and Colitis Organization (ECCO), recommend screening for latent infections, and immunization of all IBD patients, and in particular those who receive or are scheduled to start an immunosuppressive drug. However, clinical experience has revealed that it is difficult to implement these recommendations in an everyday clinical setting. Aim: To investigate if a program of systematic

information about immunization status and vaccination recommendations will increase adherence to vaccination and screening guidelines in patients with IBD on immunosuppressive therapy. Methods: Methods: The study consists of two parts: 1) An observational retrospective part including patients with IBD in in anti-TNF-α (tumor necrosis factor) therapy, and other immunosuppressive therapy from the IBD Clinic at Herlev Hospital. Patients will be interviewed regarding immunization selleck and adherence to vaccination guidelines. 2) An interventional prospective study in which healthcare professionals will receive information about international and local guidelines. Likewise patients will receive systematic information about importance of vaccination and screening. Patients

attending the IBD clinic in the study period will be included. Patients will be interviewed after one year using the same questions as in the retrospective study. Results: Endpoints: The proportions of patients in each of the two substudies who check details are: 1) fully adherent to the screening and vaccination program; 2) partially adherent; 3) completely non-adherent.

Furthermore, the physicians’, nurses’ and patients’ reasons for not following the recommendations for screening and vaccination. Conclusion: In conclusion, the study will show whether systematic information improves adherence to recommended screening and vaccination guidelines, and thereby aid to improve safety. Key Word(s): 1. IBD; 2. Immunosuppressiva; 3. Vaccination; 4. Guidelines; Presenting Author: XIAOFEI ZHANG Additional Authors: WENYU JIANG, WENJIE LI, XIUQIN CHENG, HONGJIE ZHANG Corresponding Author: HONGJIE ZHANG Affiliations: First Affiliated Hospital of Nanjing Medical University Objective: Cytokine signaling (SOCS)-3 plays an important role in autoimmune disorders. High levels of SOCS3 were observed in Crohn’s disease(CD). MicroRNAs(miRNAs) can regulate gene expression during immune responses. The aim of our study was to investigate the contribution of SOCS3 expression-associated miRNA to the regulation of chemokines production in colonic epithelial cells(CEC) in active CD. Methods: Targetscan Human 6.2 was used to screen miRNAs which may be target the 3′ untranslated region(3′ UTR) of SOCS3, and quantitative PCR was used to detect these miRNAs levels in active CD and healthy subjects. The luciferase reporter assay was performed to confirm the target gene.

1, 3, 19, 26 The current standard of care therefore relates to decreasing either the absorption of ammonia by using nonabsorbable disaccharides or either its production by reducing urease-producing bacteria by nonabsorbable antibiotics.26, 27 Recent innovations, such as rifaximin or liver

dialysis, are either not universally licensed for use or hampered because of lack of direct applicability.28-30 The ultimate solution remains liver transplantation but this implies relentless liver and renal insufficiency to become priorized in the current MELD era. Recently, large SPSSs were described to be highly prevalent Bortezomib (46%-71%) in patients with refractory HE. These latter might not only explain the refractoriness of HE but also serve as a therapeutic target.7-9, 12, 16, 31,

32 Nevertheless, the diagnosis of large SPSSs is often delayed and controversy still Everolimus concentration prevails whether SPSSs might be therapeutically targeted for HE.11, 15 To elaborate further on these issues, we pooled the datasets of six different European liver units concerning 37 patients whose data were collated into a preset standardized case-report form. Our analysis not only confirms a delayed diagnosis, as in our series the diagnosis of SPSS was made on average 13 months after onset of HE, but more importantly substantiates the therapeutic effectiveness of embolization of the considered culprit SPSSs once the diagnosis is made. More specifically, almost 50% of the treated patients became HE-free during an average follow-up of more than 2 years. Considering secondary parameters of success, defined as either improved autonomy (objectively using mRS20), or decreased number of hospitalizations or severity of the worst HE episode after embolization, an improvement was observed in three-quarters of the patients. More specifically, autonomy was improved 3-fold and as such the hospitalization rate and in-hospital stays were similarly significantly reduced. Even more important, the need for liver transplantation

click here could theoretically be reduced in a large portion of these patients, as HE was the sole presenting symptom in a substantial proportion. It was impossible to retrospectively determine if all patients had been suitable for transplantation at the time of embolization. On the other hand, if eventually deemed necessary, as was the case in one patient, embolization did not technically compromise liver transplantation. If HE recurred nevertheless, it occurred either within days after index embolization (2-7 days, n = 15) or several months later (n = 4). Given angiographic confirmation of complete occlusion of the SPSS at the end of the procedure, the early occurrence presumably relates to insufficient remnant critical functional liver mass (cfr, the higher baseline MELD of nonresponders Fig.

01). IFN production after 12 weeks of IFN therapy was significantly increased only in responders, and faithfully predicted the response. Unlike untreated aviremic patients, patients who became aviremic as a result of IFN therapy showed low IFN production by pDCs. Conclusion: The IFN-producing capacity of pDCs is closely associated with viral loads and response to IFN therapy in both adult and pediatric HCV patients. Therefore, the stimulation of endogenous IFN production by pDCs may contribute to the therapeutic efficiacy of IFN in HCV infection, and can be used as a novel method

of its prediction. The role of plasmacytoid dendritic cells in HCV pathogenesis and response IFN therapy in children, adults Key Word(s): 1. pDCs; 2. pathogenesis of HCV ; 3. IFN therapy; 4. viral loads ; Presenting

Author: GUIJIE XIN Additional Authors: LISHA SONG, XIUJUAN SHA, WEIMIN YANG Corresponding Author: GUIJIE XIN Affiliations: 1st hospital of ALK inhibitor Jilin University Objective: In recent years,most patients R788 with acute viral hepatitis E are sporadic cases, and limited epidemics have occurred in few countries.HEV is one of the main pathogens causing sporadic cases of acute hepatitis in adult in China.With high rate of HBV infection, our country has a mass of patients of chronic viral hepatitis B (CHB) or HBV-induced liver cirrhosis(HLC). So, there is a high incidence of HEV co-infection in HBV patients. The idea that HEV co-infection in patients of chronic liver can accentuate further disease had been put forward by some scholars, as well as the exist of interaction between HEV and HBV. However, no final conclusions have yet been reached on these matters.The high incidence and severe impact on prognosis of overlapping infection of HBV

and HEV cause our reflection.In this research, patients in Jilin province were investigated selleck kinase inhibitor to realize the clinical manifestations and current situation of HEV co-infection in chronic viral hepatitis B,and provide more evidences for the impaction of HEV. Methods: Retrospective analysis of 188 sporadic cases of acute hepatitis E was made,which were collected from 1st hospital of Jilin University from January 2005 to October 2011. Comparative analysis of clinical data was made between the 165 patients of HEV infection alone and 13 patients of HEV co-infection in CHB,which all came from the 188 sporadic cases of acute hepatitis E. Serological studies of anti-HEV IgM and anti-HEV IgG was made in patients with HLC,who were in hospital from December 2011 to June 2012 in 1st hospital of Jilin University. The clinical characteristics and laboratory reports of HEV co-infection of CHB and HLC were analysed. Clinical data of 165 patients of HEV infection alone and 13 patients of HEV co-infection in CHB were compared with 24 patients of HLC with positive anti-HEV IgM, which consisted of 6 sporadic cases of acute hepatitis E and 18 cases of HLC with positive anti-HEV IgM detected in this experiment test.

Fig. 2E shows the serum cytokine levels. Compared with

WT mice, IL-6−/− mice had similar levels of serum TNF-α and interferon-γ (IFN-γ), whereas IL-10−/− mice had higher levels of these cytokines in both the STD and HFD groups. Serum levels of IFN-γ were further elevated in IL-10−/−IL-6−/− GW-572016 clinical trial dKO mice versus IL-10−/− mice after HFD feeding. Finally, serum levels of IL-6 were higher in IL-10−/− mice than those in WT mice. As expected, IL-6 levels were not detected in IL-6−/− and IL-10−/−IL-6−/− dKO mice. Four lines of mice were also fed an ETOH diet and pair-fed for 4 weeks, and analyzed similarly to the studies shown in Fig. 2. In general, findings similar to the HFD model were seen in the ETOH feeding model and are described in Supporting Fig. 4. As shown in Fig. 3A,B, IL-10−/− mice were resistant to HFD-induced steatosis and serum ALT elevation compared with WT mice, which was partially restored in IL-10−/−STAT3Hep−/− dKO mice. This suggests that enhanced hepatic STAT3 activation is responsible Erlotinib for the reduced steatosis and liver injury in IL-10−/− mice after HFD feeding. Furthermore, Fig. 3C,D shows that hepatic

mRNA levels of several inflammatory markers and cytokines were highest in IL-10−/−STAT3Hep−/− mice, followed by IL-10−/− mice and WT mice in both the STD and HFD-fed groups. Serum levels of TNF-α, IFN-γ, and IL-6 were also higher in IL-10−/−STAT3Hep−/− mice than those in IL-10−/− mice (Fig. 3E). Experiments similar to the HFD model described in Fig. 3 were also performed in the ETOH model. Similar changes, albeit to a lesser extent, were observed in the ETOH model (Supporting Fig. 5). To further understand the mechanisms by which IL-10−/− mice are prone to inflammatory response but resistant to steatosis induced by HFD or ETOH diet, we examined learn more the activation of STAT3 (pSTAT3) and pSTAT1, which play an important role in controlling steatosis and liver inflammation.31 Because the HFD model induces more dramatic phenotypes compared

with the ETOH model, the studies on the underlying mechanisms were predominately focused in this HFD model. As shown in Fig. 4A, in both the STD and HFD groups, hepatic levels of pSTAT3 were lower in IL-6−/− mice but higher in IL-10−/− versus WT mice. Compared with IL-10−/− mice, IL-10−/−IL-6−/− mice had significantly lower levels of hepatic activated pSTAT3 expression, while expression of STAT3 was comparable in these two groups. Additionally, expression of pSTAT1 and STAT1 protein was higher in the HFD-fed group versus the STD group, with the greatest expression in IL-10−/− IL-6−/− mice. As expected, an additional deletion of hepatocyte STAT3 markedly reduced the expression of pSTAT3 and STAT3 in IL-10−/−STAT3Hep−/− mice compared with WT and IL-10−/− mice (Fig. 4B). Interestingly, expression of STAT1 protein was higher in these dKO mice compared with other groups (Fig. 4B).

2 (3–12)), Post-treatment Eckardt score was 0.3 (0–1). Complications related to operation included mucosa rupture in 1 (6.3%), mediastinal and subcutaneous emphysema in 4 (25%), asymptomatic pneumothorax in 2 (12.5%), gas under diaphram in 1 (6.3%). All the complications were cured by conservative treatments. ALL patients were follow-up, and no other post operation complications occurred. Conclusion: POEM is an effective, feasible and safe therapy

for achalasia, while the long-term efficacy and managements for complications are still to be elucidated. Key Word(s): 1. POEM; 2. Achalasia; Presenting Author: JINGJING WEI Additional Authors: ZEHAO Tyrosine Kinase Inhibitor Library research buy ZHUANG, JIAYUAN ZHUANG, DUPENG TANG, YILIN ZENG, CHENGDANG WANG Corresponding Author: ZEHAO ZHUANG Objective: To investigate the prevalence of gastroesophageal reflux disease (GERD) in the Hakkas and to evaluate the practicability of two questionnaires, including Chinese gastroesophageal reflux disease questionnaire

(CGQ) and gastroesophageal reflux disease questionnaire (GerdQ) in this population. Methods: CGQ and GerdQ were used for GERD symptoms survey in a random sequence in a selected Hakkas community. Results: Paired questionnaires were collected from 203 subjects, including 104 males and 99 females. The positive rates were 12.3% and 4.9% by CGQ and GerdQ, respectively (P < 0.05). A male predominant trendcy was found in GERD symptom positive cases surveyed by GerdQ (P < 0.05), but not in those surveyed

by find more CGQ (P > 0.05). The incidence of GERD showed an increasing tendency with the aging, through no significant difference was found in age-stratification analysis. The response time was 3.2 ± 0.8 min (CGQ) and 5.4 ± 0.6 min (GerdQ) respectively (P < 0.05). Conclusion: GERD symptoms were quite common in selected Hakkas community, while CGQ surveying showed a higher symptom positive rate than GerdQ surveying in this population. Key Word(s): 1. GERD; 2. GerdQ; 3. Chinese GerdQ; 4. hakka dialect; Presenting Author: LIULIU WEI Additional Authors: HONG CAI Corresponding selleck chemicals Author: LIULIU WEI Affiliations: Ganzhou city people’s hospital; Objective: To investigate the clinical characteristics and risk factors of gastroduodenal damages induced by nonsteroidal anti-inflammatory drugs (NSAIDs). Strengthen to understand the disease. Methods: The sample consisted of 85 patients whose gastroduodenal damages were induced by nonsteroidal anti-inflammatory drugs (NSAIDs) at Ganzhou city people’s hospital from the January 2011 to April 2013. According to the endoscopic diagnosis, the patients were divided into two groups, erosive gastritis group and ulcer group. Record the patients’ age, sex, clinical symptoms, previous ulcer history, H. pylori infection, smoking history and kinds of NSAIDs. Results: ① Of 85 patients of gastroduodenal damages induced by NSAIDs, male 49, female 36, the male and female ratio 1.36 : 1, mean age (61.8 ± 13.

2, 4 If patients do not respond to these drugs, experimental approaches may be applied. The molecular absorbance recirculating system (MARS) is an extracorporeal liver dialysis system capable of removing mainly Wnt inhibitor albumin-bound molecules, such as bile salts, bilirubin, ammonia, and other amphiphilic toxins. MARS therapy has been shown to effectively alleviate intractable pruritus of cholestasis in patients who do not respond to any medicinal therapy.2, 4, 5 Nasobiliary drainage transiently relieves severe pruritus

in benign recurrent intrahepatic cholestasis (BRIC)6 and primary biliary cirrhosis (PBC) patients7 who do not respond to standard antipruritic treatment.2, 4 However, pruritus may even become refractory to all medical treatments and can be an indication for liver transplantation, even in the absence of liver failure.4 By functional screening of sera of patients with cholestasis

suffering from pruritus on neuronal cells, we recently identified lysophosphatidic acid (LPA) this website as a potent neuronal activator.8 Serum levels of this phospholipid were increased in patients with cholestasis that suffered from pruritus. Circulating LPA is formed by a lysophospholipase D, called see more autotaxin (ATX), which hydrolyzes the choline group from lysophosphatidylcholine (LPC).9 In mice, the amount of circulating LPA depends on serum ATX activity.10 In line with the observed increase in LPA, ATX activity was higher in sera of patients with pruritus with cholestatic disorders, compared to those without pruritus. Furthermore, itch intensity highly correlated with ATX activity. Intradermal injection of LPA caused a dose-dependent scratch response in mice.8 ATX was initially identified as a cell motility factor, which is overexpressed in various tumors and is involved in the proliferation and generation of metastases.11

The effects of ATX are largely mediated by the enzymatic formation of LPA, which activates at least six different G-protein-coupled receptors.9, 11 ATX is also essential for angiogenesis, neuronal development, and lymphocyte homing,10 and LPA mediates the initiation of neuropathic pain, hair growth, and embryo implantation.9 Here, we studied whether increased serum ATX activity is specific for pruritus of cholestasis. We also aimed to investigate the effect of various therapeutic interventions, such as treatment with colesevelam, rifampicin (RMP), MARS, and nasobiliary drainage on ATX activity. Finally, the effects of RMP on ATX expression were studied in vitro.