Gary L. Norman, United States of America

Inova Diagnostics Research and Development
Gary Norman received his BS degree from University of Massachusetts, Amherst, MS degree from University of Washington, Seattle, and Ph.D. in Molecular Biology from University of Southern California. Following Postdoctoral Fellowships in the Dept of Clinical Chemistry, University of Toronto and Dept of Pathology, University of Southern California School of Medicine, he was appointed Assistant Professor of Pathology at USC. He moved to the Dept of Pediatric Infectious Disease at Cedars Sinai Medical Center, Beverly Hills, California with an appointment as Assistant Professor II at UCLA Medical School. He then joined MRL Reference Laboratory as Senior Scientist responsible for clinical support and development of new infectious disease assays. In 1996 he joined INOVA Diagnostics, San Diego, California and has focused on discovery and development of novel biomarkers in gastroenterology (especially IBD and celiac disease), hepatology (autoimmune liver disease), oncology (HCC and fibrosis), and anti-phospholipid disease. He has co-authored 125 peer-reviewed papers, over 250 abstracts, and has 3 awarded patents. He is a Fellow of both the American Gastroenterological Association and the American Association for the Study of Liver Disease. Over the past decade, studies and lecturing in Asia, particularly China, has been a focus of much of his professional activities.

Presenter of 1 Presentation

ANTI-GLYCOPROTEIN 2 AND PR3-ANCA ARE RISK FACTORS OF SEVERE CLINICAL PHENOTYPE, POOR OUTCOME, AND CHOLANGIOCARCINOMA IN PRIMARY SCLEROSING CHOLANGITIS

Session Type
PARALLEL SESSIONS
Date
29.05.2021, Saturday
Session Time
10:00 - 12:00
Room
HALL F
Lecture Time
10:00 - 10:10
Session Icon
Pre Recorded

Abstract

Background and Aims

Anti-glycoprotein 2(anti-GP2) and PR3-ANCA have been linked with primary sclerosing cholangitis(PSC) in which anti-GP2 IgA was suggested as a marker of disease severity and poor survival related to cholangiocarcinoma(CCA) and PR3-ANCA, as a marker of disease severity. Here we assessed anti-GP2 IgA and PR-3 ANCA as predictive factors of progressive disease course and poor outcome in a large cohort of PSC patients.

Methods

338 patients with PSC [median 32(17-73) years, 65% males, 26% cirrhotic] were prospectively evaluated. Anti-GP2 IgA (isoforms 1/4) detected by ELISAs (GA Generic Assays, Germany) and PR3-ANCA by chemiluminescence immunoassay (CIA; Inova Diagnostics, San Diego; optimized cutoff 10 units). Poor disease outcome was defined as liver transplantation and/or liver-related death during the 14 month median follow-up.

Results

Anti-GP21 IgA occurred in 23%, anti-GP24 IgA in 17%, anti-GP21 and/or GP24 IgA in 30%, and PR3-ANCA in 54.5% of patients. Anti-GP2 IgA and PR3-ANCA associated with poor liver function. Cirrhosis was associated with anti-GP24 IgA(p=0.003). CCA occurred more often in patients with anti-GP21 IgA(p=0.04) and PR3-ANCA (p=0.008). 100% of CCA patients were positive for PR3 and/or GP2 IgA. Significant associations between anti-GP21 IgA(Hazzard Ratio, HR=2.1, p=0.0008), anti-GP24 IgA(HR=2.4, p=0.005), and PR3-ANCA(HR=1.8, p=0.009) and poor outcome were found. Cox proportional-hazards regression indicated anti-GP21 IgA and lower albumin level as independent variables of poor outcome (p<0.0001), whereas anti-GP24 IgA and PR3-ANCA were independent risk factors of CCA (p=0.0019).

Conclusions

Anti-GP2 IgA and PR3-ANCA identify PSC patients at risk of poor outcome, more aggressive course, biliary cancer, and may be of prognostic value in PSC.

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