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Oka A, Kawashima K, Kishimoto K, Kotani S, Fukunaga M, Fukuba N, Mishima Y, Oshima N, Ishimura N, Awoniyi M, Ishihara S. Validation of rapid fecal calprotectin assay using particle enhanced turbidimetric immunoassay for inflammatory bowel disease. Sci Rep 2024; 14:1653. [PMID: 38238442 PMCID: PMC10796650 DOI: 10.1038/s41598-024-51580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 01/07/2024] [Indexed: 01/22/2024] Open
Abstract
Fecal calprotectin (FC) is a promising biomarker for diagnosis and treatment of inflammatory bowel disease, ulcerative colitis (UC), and Crohn's disease. An enzyme immunoassay (EIA) is widely used for FC detection, though the considerable lag time, up to several days, causes clinical management delay. This study was performed to examine the new rapid kit fCAL-turbo, which is based on a particle-enhanced turbidimetric immunoassay (15 min), by comparing FC values with other EIAs (EliA, PhiCal, Bühlmann) and endoscopic scores. Using 94 samples, fCAL-turbo showed strong significant positive correlations with the other kits (Spearman's r = 0.9178-0.9886). Of 74 UC patients, 69 underwent an endoscopy and fCAL-turbo reflected endoscopic activity with a moderate correlation with Mayo endoscopic subscore (MES) (r = 0.6945, others r = 0.6682-0.7013). Receiver operating characteristic analyses based on MES 0 versus 1-3 showed a similar efficacy as compared to the other kits (cut-off and area under the curve: 89.70 µg/g and 0.8592, respectively, others 62.35-138.4 µg/g and 0.8280-0.8611, respectively). Furthermore, multiple regression analysis confirmed that fCAL-turbo results significantly contributed to prediction of MES 0 with a higher t-value as compared to the other biomarkers. fCAL-turbo showed strong correlations with the other kits and also demonstrated excellent performance for predicting endoscopic remission of UC.
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Affiliation(s)
- Akihiko Oka
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Kousaku Kawashima
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan.
- Inflammatory Bowel Disease Center, Shimane University Hospital, Izumo, Shimane, Japan.
- Department of Internal Medicine, Matsue Seikyo General Hospital, Matsue, Shimane, Japan.
| | - Kenichi Kishimoto
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Satoshi Kotani
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Mai Fukunaga
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Nobuhiko Fukuba
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Yoshiyuki Mishima
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Naoki Oshima
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Norihisa Ishimura
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
| | - Muyiwa Awoniyi
- Department of Inflammation and Immunity, Digestive Disease and Surgery Institute, Division of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Shunji Ishihara
- Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1, Izumo, Shimane, 693-8501, Japan
- Inflammatory Bowel Disease Center, Shimane University Hospital, Izumo, Shimane, Japan
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Handley S, Dote N, Wanandy T, Prentice L. Verification of the Bühlmann fCAL turbo faecal calprotectin assay on the Binding Site Optilite benchtop analyser. Pract Lab Med 2023; 36:e00318. [PMID: 37649548 PMCID: PMC10462488 DOI: 10.1016/j.plabm.2023.e00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 12/18/2022] [Accepted: 06/19/2023] [Indexed: 09/01/2023] Open
Abstract
Objectives Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are increasingly prevalent disorders. Faecal calprotectin is useful in the differential diagnosis of IBD from IBS and monitoring IBD activity. We verified the Bühlmann fCAL turbo faecal calprotectin assay on the Binding Site, Optilite benchtop analyser. Design Accuracy, precision, lower limit of quantitation (LLoQ), and linearity of the Bühlmann fCAL turbo faecal calprotectin assay on the Binding Site, Optilite benchtop analyser were ascertained. Comparison with the Bühlmann Quantum Blue fCAL extended and DiaSorin, Liaison calprotectin assays were also undertaken. Difference between assays was evaluated using the Wilcoxon signed-rank test and method comparison was undertaken using Spearman's rank correlation (rs), difference plots and Passing-Bablok regression analyses. Results The fCAL turbo assay was linear between 25 and 10,000 μg/g, and the LLoQ was 25 μg/g. Intra-, and inter-assay imprecision was <5%. There was a good agreement (rs = 0.96) and no significant bias (3%, p = 0.10) present between the fCAL turbo and Quantum Blue extended assays. Between the fCAL turbo and DiaSorin, liaison assays there was a good agreement (rs = 0.97), but a significant bias (53%, p = <0.01) was present. Conclusions The fCAL turbo assay performs well on the Binding Site, Optilite benchtop analyser. Calprotectin results are commutable between with Bühlmann fCAL turbo and Quantum Blue fCAL extended assays, but not between Bühlmann and DiaSorin calprotectin assays.
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Affiliation(s)
- S.A. Handley
- Biochemistry, Department of Pathology, Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, Australia
- School of Medicine, University of Tasmania, Menzies Institute for Medical Research, Level 1, Medical Science 1, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia
| | - N.P. Dote
- Biochemistry, Department of Pathology, Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, Australia
| | - T. Wanandy
- School of Medicine, University of Tasmania, Menzies Institute for Medical Research, Level 1, Medical Science 1, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia
- Department of Clinical Immunology and Allergy, Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, Australia
| | - L. Prentice
- Biochemistry, Department of Pathology, Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania, 7000, Australia
- School of Medicine, University of Tasmania, Menzies Institute for Medical Research, Level 1, Medical Science 1, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia
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Validation of the newly FDA-approved Buhlmann fCal Turbo assay for measurement of fecal calprotectin in a pediatric population. Pract Lab Med 2020; 22:e00178. [PMID: 33134465 PMCID: PMC7585138 DOI: 10.1016/j.plabm.2020.e00178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022] Open
Abstract
Objectives Inflammatory bowel disease (IBD) is an increasingly prevalent disorder marked by chronic intestinal inflammation. Fecal calprotectin has emerged as a useful biomarker for differential diagnostics and monitoring IBD activity. We validated the newly FDA-approved fCal Turbo fecal calprotectin assay in our pediatric hospital. Design and methods The performance of the fCal Turbo assay was assessed on the Vitros 5600 analyzer (Ortho Clinical Diagnostics, USA), including limit of quantitation, linearity, precision, and interference studies. Method comparison was performed with 20 fecal samples with the Buhlmann fCal ELISA, and reference range verification was performed with 33 fecal samples. Results The fCal Turbo assay on the Vitros 5600 was linear between 33.1 and 14,182.5 μg/g, with dilution studies extending the range to 33.1–22,000 μg/g, Reproducibility of the assay met acceptability criteria, with intra-assay CV of 0.3–3.2% and inter-assay CV of 5.2–8.9%. Interference studies identified acceptable thresholds for protein, bilirubin, and lipids. We verified a reference range of 33.1–60 μg/g in our patient population. Deming regression identified acceptable correlation with minor positive bias (2.7%) between the fCal Turbo and fCal ELISA methods. Conclusions The fCal Turbo assay performs well on the Vitros 5600 analyzer in our patient population, with the assay being easy to use in our routine chemistry workflow. We anticipate that the fCal Turbo assay will be useful as a rapid screening method for differential diagnostics and disease monitoring of IBD in our patient population. We validated the fCal Turbo fecal calprotectin assay for pediatric population use. This assay meets performance criteria, but cannot be used with turbid specimens. This automated assay compares favorably to standard ELISA for turnaround time.
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Qin Y, Wu Y, Feng M, Wang Y, Zhao X, Gao C, Guo H, Luo J. Evaluation of a novel latex enhanced turbidimetric immunoassay for detecting autoantibody against extractable nuclear antigens. EUR J INFLAMM 2020. [DOI: 10.1177/2058739220961187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Detection of autoantibody against extractable nuclear antigens (ENAs) plays a critical role in the diagnosis and management of autoimmune diseases.In this study, we assessed the performance of LETIA in detecting anti-ENAs. Total 606 serum samples from the Second Hospital of Shanxi Medical University were collected. Anti-SSA, anti-SSB, anti-Sm, anti-U1-snRNP, and anti-Sm/RNP were parallelly detected by LETIA and line immunoblot (LIA). Besides, this study assessed LETIA for its repeatability in detecting anti-ENAs autoantibodies, and consistency with LIA. A receiver operating characteristic (ROC) curves was drawn to assess the accuracy of LETIA. The LETIA and LIA showed high coincidence rate in detecting anti-SSA, anti-SSB, anti-Sm, anti-U1-snRNP, and anti-Sm/RNP autoantibodies, with the results being 87.22%, 96.61%, 97.03%, 88.28%, and 92.06%, respectively. Almost perfect consistency (kappa > 0.8) were found in the detection of anti-SSB and anti-Sm by LETIA and LIA. While in the detection of anti-SSA, anti-U1-snRNP, and anti-Sm/RNP, moderate consistency (0.6 ⩽ kappa ⩽ 0.8) were shown. The AUCs of anti-SSA, anti-SSB, anti-Sm, anti-U1-snRNP, and anti-Sm/RNP detected by LETIA were 0.972 (95% confidence interval (CI): 0.941–1.000, p < 0.001), 0.986 (95% CI: 0.967–1.000, p < 0.001), 0.912 (95% CI: 0.763–1.000, p < 0.001), 0.829 (95% CI: 0.731–0.928, p < 0.001), and 0.828 (95% CI: 0.715–0.941, p < 0.001), respectively. LETIA and LIA showed considerable consistency in detecting anti-ENAs. Moreover, with the pronounced advantages of automatic and rapid detection, and high universality, LETIA can meet the requirements for quantitative detection of anti-ENAs.
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Affiliation(s)
- Yan Qin
- The Shanxi Medical University, Wuyi Road, Taiyuan, Shanxi, China
| | - Yanyao Wu
- The Shanxi Medical University, Wuyi Road, Taiyuan, Shanxi, China
| | - Min Feng
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yanlin Wang
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiangcong Zhao
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chong Gao
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Hui Guo
- Division of Nephrology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Division of Nephrology, Department of Medicine, Shenzhen Baoan shiyan People’s Hospital, Shenzhen, Guangdong, China
| | - Jing Luo
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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Kadim M, Hegar B, Bardosono S, Timan IS, Gunardi H, Prasetyo D, Firmansyah A, Vandenplas Y. Effect of Supplementation of Zinc, Glutamine, Fiber, and Prebiotics in Presumed Healthy Indonesian Children Aged 1-3 Years. Pediatr Gastroenterol Hepatol Nutr 2020; 23:388-396. [PMID: 32704499 PMCID: PMC7354871 DOI: 10.5223/pghn.2020.23.4.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/05/2020] [Accepted: 03/01/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Impaired intestinal mucosal integrity may affect the gastrointestinal function, especially in relation to nutrition, absorption, and barrier function. The purpose of this study was to measure the prevalence of impaired intestinal mucosal integrity in presumed healthy children aged 1-3 years and assess the effects of zinc, glutamine, fiber, and prebiotic supplementation in them. METHODS A cross-sectional study was conducted in 200 children aged 1-3 years in Pasar Minggu, South Jakarta, Indonesia. A randomized double-blind parallel group method clinical trial was then performed to assess the effects of zinc, glutamine, fiber, and prebiotic supplementation. RESULTS Elevated calprotectin was found in 91/200 subjects (45.5%) at the onset of the study. After 10 months, 144 subjects completed the study: 72 subjects received the trial formula, whereas the other 72 received the standard formula. A transitory decrease in fecal calprotectin (FC) was observed after 6 months in the subgroup with normal FC levels, who were fed the test formula (p=0.012). CONCLUSION The prevalence of impaired intestinal mucosal integrity in this group of Indonesian children aged 1-3 years was high. Supplementation with zinc, glutamine, fiber, and prebiotics during 6 months reduced FC only in those who had low levels at baseline but not in those with impaired integrity.
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Affiliation(s)
- Muzal Kadim
- Department of Child Health, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Badriul Hegar
- Department of Child Health, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Saptawati Bardosono
- Department of Nutrition, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ina S Timan
- Department of Clinical Phatology Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hartono Gunardi
- Department of Child Health, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dwi Prasetyo
- Department of Child Health, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - Agus Firmansyah
- Department of Child Health, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Yvan Vandenplas
- KidZ Health Castle, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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Berinstein JA, Steiner CA, Bousvaros A, Tiongco FP, Greenberg E, Hardi R, Lembo AJ, Friedenberg K, Sedghi S, Fint A, Florez DA, Kumar A, Arsenescu R, Park KT, Kupchak P, Grob A, Leavitt J, Higgins PDR. The Clinical Accuracy of the BÜHLMANN fCAL ELISA in the Differentiation of Inflammatory Bowel Disease From Irritable Bowel Syndrome: A Multicenter Prospective Case–Control Study. CROHN'S & COLITIS 360 2019. [DOI: 10.1093/crocol/otz037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Fecal calprotectin (fCAL) is a noninvasive biomarker used to differentiate between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).
Methods
A multicenter prospective case–control study evaluating the BÜHLMANN fCAL enzyme-linked immunosorbent assay (ELISA) was conducted in 478 subjects. Sensitivity, specificity, predictive values, and area under the receiver operator characteristic (AuROC) curve are reported and compared to another device.
Results
In differentiating IBD from IBS, the BÜHLMANN fCAL ELISA is very sensitive (93.3%) at a cutoff <80 μg/g and balanced sensitivity (84.4%) and specificity (85.4%) at a cutoff >160 μg/g (AuROC 0.933).
Conclusions
The BÜHLMANN fCAL ELISA demonstrates excellent discriminating between IBD and IBS.
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Affiliation(s)
- Jeffrey A Berinstein
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
| | - Calen A Steiner
- Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI
| | - Athos Bousvaros
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
| | - Felix P Tiongco
- Clinical Research Division, Gastroenterology Associates of Tidewater, Chesapeake, VA
| | - Eugene Greenberg
- Clinical Research Division, Greenberg Digestive Health Institute/Carle Foundation, Urbana, IL
| | - Robert Hardi
- George Washington University School of Medicine & Health Sciences, Washington, DC
| | - Anthony J Lembo
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA
| | | | | | | | | | | | - Razvan Arsenescu
- Atlantic Inflammatory Bowel Disease Center of Excellence, Atlantic Digestive Health Institute, Morristown, NJ
| | - K T Park
- Division of Gastroenterology, Hepatology, and Nutrition, Stanford University School of Medicine, Palo Alto, CA
| | | | | | | | - Peter D R Higgins
- Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI
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Vavricka SR, Heinrich H, Buetikofer S, Breitenmoser F, Burri E, Schneider-Yin X, Barman-Aksoezen J, Biedermann L, Scharl M, Zeitz J, Rogler G, Misselwitz B, Sauter M. The Vampire Study: Significant elevation of faecal calprotectin in healthy volunteers after 300 ml blood ingestion mimicking upper gastrointestinal bleeding. United European Gastroenterol J 2018; 6:1007-1014. [PMID: 30228888 DOI: 10.1177/2050640618774416] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/04/2018] [Indexed: 12/28/2022] Open
Abstract
Background Faecal calprotectin correlates with histological and clinical activity in inflammatory bowel disease. Gastrointestinal bleeding might also increase faecal calprotectin levels, erroneously implying intestinal inflammation; however, this possibility has not been systematically assessed. Methods Sixteen healthy volunteers without gastrointestinal disease and normal faecal calprotectin baseline values ingested their own blood twice, either by drinking or via nasogastric tube. Quantities of 100 ml and 300 ml blood were ingested in a randomised order, with a 28-day wash-out period. Faecal calprotectin, faecal occult blood test, and the occurrence of melaena were assessed. Faecal calprotectin ≥ 50 µg/g was considered elevated. Results Melaena was reported by all healthy volunteers after 300 ml and by 11/15 healthy volunteers (71%) after 100 ml blood ingestion. One day after ingestion of 300 ml blood, 8/16 faecal calprotectin tests were positive compared to 1/16 at baseline (p = 0.016). Faecal calprotectin levels above > 200 µg/g were rarely observed. There was a trend for faecal calprotectin test positivity also after ingestion of 100 ml. Conclusion Ingestion of blood resulted in an increase in faecal calprotectin-positive tests. Gastrointestinal bleeding should be considered as a potential cause of mild faecal calprotectin elevation > 50 µg/g; however, increased faecal calprotectin above > 250-300 µg/g, the established cut-off for relevant intestinal inflammation in patients with inflammatory bowel disease, is rare.
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Affiliation(s)
- Stephan R Vavricka
- Department of Medicine, Division of Gastroenterology, Triemli Hospital, Zurich, Switzerland.,Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Gastroenterology, St Claraspital, Basel, Switzerland
| | - Henriette Heinrich
- Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Gastroenterology, St Claraspital, Basel, Switzerland
| | - Simon Buetikofer
- Department of Medicine, Division of Gastroenterology, Triemli Hospital, Zurich, Switzerland.,Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Flavia Breitenmoser
- Department of Medicine, Division of Gastroenterology, Triemli Hospital, Zurich, Switzerland
| | - Emanuel Burri
- Department of Gastroenterology, Cantonal Hospital, Liestal, Switzerland
| | | | | | - Luc Biedermann
- Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Scharl
- Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Jonas Zeitz
- Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gerhard Rogler
- Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Benjamin Misselwitz
- Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Matthias Sauter
- Department of Medicine, Division of Gastroenterology, Triemli Hospital, Zurich, Switzerland.,Division of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Gastroenterology, St Claraspital, Basel, Switzerland
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