PDF下载 ( 1622 KB)
Current status of diagnosis and treatment of primary biliary cholangitis and related challenges in China
-
摘要:
原发性胆汁性胆管炎最早被命名为原发性胆汁性肝硬化,是一种慢性胆汁淤积性肝病,其特点是免疫介导的中小胆管的破坏。近些年,随着人们对该病认识的不断提高,新型免疫学与病理学检测技术的广泛应用,我国在该病的诊断和治疗等方面逐渐与国际接轨,同时也取得了一系列具有创新性的临床研究发现和成果。对上述成果进行全面的综述,并提出未来我国将要面临的相关挑战及可能的应对措施。
Abstract:Primary biliary cholangitis,once named primary biliary cirrhosis,is a chronic cholestatic liver disease characterized by immune-mediated damage of small and medium-sized bile ducts. Recently,with the improvement in the knowledge of this disease and the wide application of new immunological and pathological detection techniques,the gap between China and Western countries in the diagnosis and treatment of PBC has been gradually narrowed,and a series of innovative findings and results have also been achieved. This article reviews these achievements and points out future challenges and possible solutions.
-
Key words:
- liver cirrhosis /
- biliary /
- diagnosis /
- therapy
-
[1]BEUERS U,GERSHWIN ME,GISH RG,et al.Changing nomenclature for PBC:From cirrhosis to cholangitis[J].Clin Gastroenterol Hepatol,2015,110(11):1536-1538. [2]HAMLYN AN,SHERLOCK S.The epidemiology of primary biliary cirrhosis:a survey of mortality in England and Wales[J].Gut,1974,15(6):473-479. [3]YAO GB.A prospective study of primary biliary cirrhosis in Chinese patients[J].Chin Hepatol,2002,7(3):146-149.(in Chinese)姚光弼.中国人原发性胆汁性肝硬化的前瞻性研究[J].肝脏,2002,7(3):146-149. [4]LIU H,LIU Y,WANG L,et al.Prevalence of primary biliary cirrhosis in adults referring hospital for annual health check-up in Southern China[J].BMC Gastroenterol,2010,10(1):1-5. [5]WANG L,GERSHWIN ME,WANG FS.Primary biliary cholangitis in China[J].Curr Opin Gastroenterol,2016,32:195-203. [6]CHAN CY,LEE SD,HUANG YS,et al.Primary biliary cirrhosis in Taiwan[J].J Gastroenterol Hepatol,1990,5(5):560-565. [7]WONG GL,HUI AY,WONG VW,et al.A retrospective study on clinical features and prognostic factors of biopsy-proven primary biliary cirrhosis in Chinese patients[J].Am J Gastroenterol,2005,100(10):2205-2211. [8] GU EL,YAO GB.The clinical characteristics of primary biliary cirrhosis in China:a systematic review[J].Chin J Hepatol,2009,17(11):861-866.(in Chinese)顾而立,姚光弼.中国人原发性胆汁性肝硬化的临床特点:52年文献的系统分析[J].中华肝脏病杂志,2009,17(11):861-866. [9]JIN Q,MORITOKI Y,LLEO A,et al.Comparative analysis of portal cell infiltrates in antimitochondrial autoantibody-positive versus antimitochondrial autoantibody-negative primary biliary cirrhosis[J].Hepatology,2012,55(5):1495-1506. [10]GARRED P,LYON H,CHRISTOFFERSEN P,et al.Deposition of C3,the terminal complement complex and vitronectin in primary biliary cirrhosis and primary sclerosing cholangitis[J].Liver,1993,13(6):305-310. [11]POPPER H,SCHAFFNER F.Nonsuppurative destructive chronic cholangitis and chronic hepatitis[J].Prog Liver Dis,1970,3(3):336-354. [12]WU CH,XU XY,LU HY,et al.Clinical and pathological analysis of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome[J].J Peking Univ:Health Sci,2005,36(6):609-611.(in Chinese)吴赤红,徐小元,陆海英.原发性胆汁性肝硬化-自身免疫性肝炎重叠综合征患者的临床和病理分析[J].北京大学学报:医学版,2005,36(6):609-611. [13]LIU F,PAN ZG,YE J,et al.Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome:simplified criteria may be effective in the diagnosis in Chinese patients[J].J Dig Dis,2014,15(12):660-668. [14]WANG Q,SELMI C,ZHOU X,et al.Epigenetic considerations and the clinical reevaluation of the overlap syndrome between primary biliary cirrhosis and autoimmune hepatitis[J].J Autoimmun,2013,41:140-145. [15]YANG F,WANG Q,WANG Z,et al.The natural history and prognosis of primary biliary cirrhosis with clinical features of autoimmune hepatitis[J].Clin Rev Allergy Immunol,2016,50(1):114-123. [16]LINDOR KD,GERSHWIN ME,POUPON R,et al.Primary biliary cirrhosis[J].Hepatology,2009,50(1):291-308. [17]HU CJ,SONG G,HUANG W,et al.Identification of new autoantigens for primary biliary cirrhosis using human proteome microarrays[J].Mol Cell Proteomics,2012,11(9):669-680. [18]NORMAN GL,YANG CY,OSTENDORFF HP,et al.Anti-kelchlike 12 and anti-hexokinase 1:novel autoantibodies in primary biliary cirrhosis[J].Liver Int,2015,35(2):642-651. [19]LI YZ,HU CJ,LENG XM,et al.Promising diagnostic biomarkers for primary biliary cirrhosis identified with magnetic beads and MALDI-TOF-MS[J].Anat Rec(Hoboken),2009,292(3):455-460. [20]TAN Y,PAN T,YE Y,et al.Serum microRNAs as potential biomarkers of primary biliary cirrhosis[J].PLo S One,1932,9(10):e111424. [21]LIAN JS,LIU W,HAO SR,et al.A serum metabolomic analysis for diagnosis and biomarker discovery of primary biliary cirrhosis and autoimmune hepatitis[J].Hepatobiliary Pancreat Dis Int,2015,14(4):413-421. [22]WENZEL JS,DONOHOE A,FORD KL 3rd,et al.Primary biliary cirrhosis:MR imaging findings and description of MR imaging periportal halo sign[J].AJR Am J Roentgenol,2001,176(4):885-889. [23]KOVAC JD,JESIC R,STANISAVLEVIC D,et al.Integrative role of MRI in the evaluation of primary biliary cirrhosis[J].Eur Radiol,2012,22(3):688-694. [24]ZHANG DK,CHEN M,LIU Y,et al.Acoustic radiation force impulse elastography for non-invasive assessment of disease stage in patients with primary biliary cirrhosis:a preliminary study[J].Clin Radiol,2014,69(8):836-840. [25]WANG H,JIANG W,ZHOU Z,et al.Liver transplantation in mainland China:the overview of CLTR 2011 annual scientific report[J].Hepatobiliary Surg Nutr,2013,2(4):188-197. [26]HWANG SJ,CHAN CY,LEE SD,et al.Ursodeoxycholic acid in the treatment of primary biliary cirrhosis:a short-term,randomized,double-blind controlled,cross-over study with long-term follow up[J].J Gastroenterol Hepatol,1993,8(3):217-223. [27]ZHANG LN,SHI TY,SHI XH,et al.Early biochemical response to ursodeoxycholic acid and long-term prognosis of primary biliary cirrhosis:results of a 14-year cohort study[J].Hepatology,2013,58(1):264-272. [28]TRIVEDI PJ,HIRSCHFIELD GM,GERSHWIN ME.Obeticholic acid for the treatment of primary biliary cirrhosis[J].Expert Rev Clin Pharmacol,2016,9(1):13-26. [29]FIERABRACCI A,del FATTORE A,MURACA M,et al.The use of mesenchymal stem cells for the treatment of autoimmunity:from animals models to human disease[J].Curr Drug Targets,2016,17(2):229-238. [30]WANG D,ZHANG H,LIANG J,et al.Effect of allogeneic bone marrow-derived mesenchymal stem cells transplantation in a poly I:C-induced primary biliary cirrhosis mouse model[J].Clin Exp Med,2011,11(1):25-32. [31]WANG L,LI J,LIU H,et al.A pilot study of umbilical cord-derived mesenchymal stem cell transfusion in patients with primary biliary cirrhosis[J].J Gastroenterol Hepatol,2013,1(Suppl 1):85-92. [32]WANG L,HAN Q,CHEN H,et al.Allogeneic bone marrow mesenchymal stem cell transplantation in patients with UDCA-resistant primary biliary cirrhosis[J].Stem Cells Dev,2014,23(20):2482-2489. [33]HAGEY LR,CROMBIE DL,ESPINOSA E,et al.Ursodeoxycholic acid in the Ursidae:biliary bile acids of bears,pandas,and related carnivores[J].J Lipid Res,1993,34(11):1911-1917. [34]HOHENESTER S,OUDE-ELFERINK RP,BEUERS U.Primary biliary cirrhosis[J].Semin Immunopathol,2009,31(3):283-307. [35]ONJI M,CUI M.Clinical efficacy of UDCA combined with Jun Chen Hao decoction in treatment of jaundice for PBC patients[J].Foreign Med Sci,1991,13(6):5-7.(in Chinese)ONJI M,崔蒙.并用熊去氧胆酸和茵陈蒿汤治疗原发性胆汁性肝硬化黄疸患者[J].国外医学:中医中药分册,1991,13(6):5-7. [36]JIANG J,HE M.Clinical features of primary biliary cirrhosis and treatment of it by integrated traditional Chinese and western medicine[J].J Chin Integr Med,2003,1(2):99-102.(in Chinese)蒋健,何淼.原发性胆汁性肝硬化的临床特征及中西医结合治疗探讨[J].中西医结合学报,2003,1(2):99-102. [37]TONG GD,TANG HH,WEI CS,et al.Efficacy of ursodeoxycholic acid combined with Tongdan decoction on immunological indices and histopathologcial changes in primary biliary cirrhosis patients[J].Chin J Integr Med,2012,18(1):16-22. [38]DU Y,FANG L.Clinical efficacy of traditional Chinese medicine/herbal decoction combined with ursodeoxycholic acid for primary biliary cirrhosis:a meta analysis[J].J Clin Hepatol,2015,31(1):68-73.(in Chinese)杜莹,方蕾.中药汤剂/中成药联合熊去氧胆酸治疗原发性胆汁性肝硬化疗效的Meta分析[J].临床肝胆病杂志,2015,31(1):68-73. [39]WANG L,WANG FS,CHANG C,et al.Breach of tolerance:primary biliary cirrhosis[J].Semin Liver Dis,2014,34(3):297-317. [40]YOU Z,WANG Q,BIAN Z,et al.The immunopathology of liver granulomas in primary biliary cirrhosis[J].J Autoimmun,2012,39(3):216-221. [41]WANG YH,YANG W,YANG JB,et al.Systems biologic analysis of T regulatory cells genetic pathways in murine primary biliary cirrhosis[J].J Autoimmun,2015,59:26-37. [42]WANG L,SUN Y,ZHANG Z,et al.CXCR5+CD4+T follicular helper cells participate in the pathogenesis of primary biliary cirrhosis[J].Hepatology,2015,61(2):627-638. [43]LI Y,WANG W,TANG L,et al.Chemokine(C-X-C motif)ligand 13 promotes intrahepatic chemokine(C-X-C motif)receptor 5+lymphocyte homing and aberrant B-cell immune responses in primary biliary cirrhosis[J].Hepatology,2015,61(10):1998-2007. [44]PENG A,KE P,ZHAO R,et al.Elevated circulating CD14low CD16+monocyte subset in primary biliary cirrhosis correlates with liver injury and promotes Th1 polarization[J].Clin Exp Med,2015.[Epub ahead of print] -
本文二维码
计量
- 文章访问数: 2246
- HTML全文浏览量: 8
- PDF下载量: 647
- 被引次数: 0
下载:
