自身免疫性肝病重叠综合征的研究现状

倪萍; 凡小丽; 杨丽

doi:10.3969/j.issn.1001-5256.2020.04.006

自身免疫性肝病重叠综合征的研究现状

DOI: 10.3969/j.issn.1001-5256.2020.04.006

四川大学华西医院消化内科

基金项目:

国家自然科学基金面上项目(81770568)；

详细信息

中图分类号: R575
计量
- 文章访问数: 1759
- HTML全文浏览量: 23
- PDF下载量: 410
- 被引次数: 0
出版历程
- 收稿日期: 2020-03-04
- 出版日期: 2020-04-20

Current status of research on overlap syndrome of autoimmune liver disease

Department of Gastroenterology,West China Hospital,Sichuan University

Research funding:

摘要

摘要: 自身免疫性肝病主要包括原发性胆汁性胆管炎（PBC）、自身免疫性肝炎（AIH）和原发性硬化性胆管炎（PSC）。同时或相继出现以上任意两种单独自身免疫性肝病特征者称为重叠综合征。其中,以PBC重叠AIH（PBC-AIH）相对最为常见。若不及时接受治疗可迅速进展至肝硬化和肝衰竭。就近年自身免疫性肝病重叠综合征的研究进展进行了总结。
- 胆管炎,硬化性 /
- 肝硬化,胆汁性 /
- 肝炎,自身免疫性 /
- 重叠综合征
Abstract: Autoimmune liver diseases mainly include primary biliary cholangitis( PBC),autoimmune hepatitis( AIH),and primary sclerosing cholangitis. Simultaneous or successive occurrence of the features of any two of the above diseases is called overlap syndrome,among which PBC-AIH overlap syndrome is the most common type. Overlap syndrome can progress rapidly to liver cirrhosis and liver failure without timely treatment. This article summarizes the research advances in overlap syndrome of autoimmune liver disease in recent years.
- cholangitis,sclerosing /
- liver cirrhosis,biliary /
- hepatitis,autoimmune /
- overlap syndrome

HTML全文

参考文献(57)

[1] TANAKA A,MA X,YOKOSUKA O,et al. Autoimmune liver diseases in the Asia-Pacific region:Proceedings of APASL symposium on AIH and PBC 2016[J]. Hepatol Int,2016,10(6):909-915.

[2] CHAZOUILLRES O. Overlap syndromes[J]. Dig Dis,2015,33(Suppl 2):181-187.

[3] JOSHITA S,UMEMURA T,TANAKA E,et al. Genetics and epigenetics in the pathogenesis of primary biliary cholangitis[J]. Clin J Gastroenterol,2018,11(1):11-18.

[4] LV T,LI M,ZENG N,et al. Systematic review and meta-analysis on the incidence and prevalence of autoimmune hepatitis in Asian,European,and American population[J]. J Gastroenterol Hepatol,2019,34(10):1676-1684.

[5] BOBERG KM,CHAPMAN RW,HIRSCHFIELD GM,et al. Overlap syndromes:The International Autoimmune Hepatitis Group(IAIHG)position statement on a controversial issue[J]. J Hepatol,2011,54(2):374-385.

[6] CZAJA AJ. Frequency and nature of the variant syndromes of autoimmune liver disease[J]. Hepatology,1998,28(2):360-365.

[7] CHAZOUILLRES O,WENDUM D,SERFATY L,et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome:Clinical features and response to therapy[J]. Hepatology,1998,28(2):296-301.

[8] European Association for the Study of the Liver. EASL Clinical Practice Guidelines:The diagnosis and management of patients with primary biliary cholangitis[J]. J Hepatol,2017,67(1):145-172.

[9] European Association for the Study of the Liver. EASL clinical practice guidelines:Autoimmune hepatitis[J]. J Hepatol,2015,63(4):971-1004.

[10] WANG TT,LU CL,FAN XL,et al. Clinical and pathological features of autoimmune hepatitis-primary biliary cholangitis overlap syndrome versus autoimmune hepatitis[J]. J Clin Hepatol,2017,33(11):2179-2185.(in Chinese)王婷婷，鲁昌立，凡小丽，等．自身免疫性肝炎-原发性胆汁性胆管炎重叠综合征的临床及病理学特征分析[J]．临床肝胆病杂志，2017,33(11):2179-2185.

[11] TAN XY,MIAO Q,CHEN XY. Clinicopathological analysis of anti-mitochondrial antibody negative primary biliary cholangitis-autoimmune hepatitis overlap syndrome[J]. Chin J Hepatol,2019,27(5):376-380.(in Chinese)谭晓燕，苗琪，陈晓宇．抗线粒体抗体阴性原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征的临床病理分析[J]．中华肝脏病杂志，2019,27(5):376-380.

[12] LEE BT,WANG Y,YANG A,et al. IgG:IgM ratios of liver plasma cells reveal similar phenotypes of primary biliary cholangitis with and without features of autoimmune hepatitis[J]. Clin Gastroenterol Hepatol,2019.[Epub ahead of print]

[13] KUIPER EM,ZONDERVAN PE,van BUUREN HR. Paris criteria are effective in diagnosis of primary biliary cirrhosis and autoimmune hepatitis overlap syndrome[J]. Clin Gastroenterol Hepatol,2010,8(6):530-534.

[14] CZAJA AJ. Diagnosis and management of the overlap syndromes of autoimmune hepatitis[J]. Can J Gastroenterol,2013,27(7):417-423.

[15] ALVAREZ F,BERG PA,BIANCHI FB,et al. International Autoimmune Hepatitis Group Report:Review of criteria for diagnosis of autoimmune hepatitis[J]. J Hepatol,1999,31(5):929-938.

[16] MANNS MP,CZAJA AJ,GORHAM JD,et al. Diagnosis and management of autoimmune hepatitis[J]. Hepatology,2010,51(6):2193-2213.

[17] TALWALKAR JA,KEACH JC,ANGULO P,et al. Overlap of autoimmune hepatitis and primary biliary cirrhosis:An evaluation of a modified scoring system[J]. Am J Gastroenterol,2002,97(5):1191-1197.

[18] HENNES EM,ZENIYA M,CZAJA AJ,et al. Simplified criteria for the diagnosis of autoimmune hepatitis[J]. Hepatology,2008,48(1):169-176.

[19] WIEGARD C,SCHRAMM C,LOHSE AW. Scoring systems for the diagnosis of autoimmune hepatitis:Past,present,and future[J]. Semin Liver Dis,2009,29(3):254-261.

[20] MACK CL,ADAMS D,ASSIS DN,et al. Diagnosis and management of autoimmune hepatitis in adults and children:2019practice guidance and guidelines from the American Association for the study of liver diseases[J]. Hepatology,2019.[Epub ahead of print]

[21] 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.

[22] ZHANG W,DE D,MOHAMMED KA,et al. New scoring classification for primary biliary cholangitis-autoimmune hepatitis overlap syndrome[J]. Hepatol Commun,2018,2(3):245-253.

[23] LINDOR KD,GERSHWIN ME,POUPON R,et al. Primary biliary cirrhosis[J]. Hepatology,2009,50(1):291-308.

[24] JOSHI S,CAUCH-DUDEK K,WANLESS IR,et al. Primary biliary cirrhosis with additional features of autoimmune hepatitis:Response to therapy with ursodeoxycholic acid[J]. Hepatology,2002,35(2):409-413.

[25] CHAZOUILLRES O,WENDUM D,SERFATY L,et al. Long term outcome and response to therapy of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome[J]. J Hepatol,2006,44(2):400-406.

[26] OZASLAN E,EFE C,HEURGU-BERLOT A,et al. Factors associated with response to therapy and outcome of patients with primary biliary cirrhosis with features of autoimmune hepatitis[J]. Clin Gastroenterol Hepatol,2014,12(5):863-869.

[27] NICOLL AJ,ROBERTS SK,LIM R,et al. Beneficial response to mycophenolate mofetil by patients with autoimmune hepatitis who have failed standard therapy,is predicted by older age and lower immunoglobulin G and INR levels[J]. Aliment Pharmacol Ther,2019,49(10):1314-1322.

[28] HANOUNEH M,RITCHIE MM,ASCHA M,et al. A review of the utility of tacrolimus in the management of adults with autoimmune hepatitis[J]. Scand J Gastroenterol,2019,54(1):76-80.

[29] BAVEN-PRONK AM,COENRAAD MJ,van BUUREN HR,et al. The role of mycophenolate mofetil in the management of autoimmune hepatitis and overlap syndromes[J]. Aliment Pharmacol Ther,2011,34(3):335-343.

[30] SHEN Y,FAN X,YANG X,et al. Letter:Tacrolimus may be hazardous in decompensated autoimmune liver disease with hyperbilirubinaemia[J]. Aliment Pharmacol Ther,2018,47(11):1566-1568.

[31] FAN X,ZHU Y,MEN R,et al. Efficacy and safety of immunosuppressive therapy for PBC-AIH overlap syndrome accompanied by decompensated cirrhosis:A real-world study[J].Can J Gastroenterol Hepatol,2018,2018:1965492.

[32] TRIVEDI PJ,HIRSCHFIELD GM. Review article:Overlap syndromes and autoimmune liver disease[J]. Aliment Pharmacol Ther,2012,36(6):517-533.

[33] CZAJA AJ,CARPENTER HA. Autoimmune hepatitis overlap syndromes and liver pathology[J]. Gastroenterol Clin North Am,2017,46(2):345-364.

[34] 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.

[35] MARTNEZ CASAS OY,DAZ RAMREZ GS,MARN ZULUAGA JI,et al. Autoimmune hepatitis-primary biliary cholangitis overlap syndrome. Long-term outcomes of a retrospective cohort in a university hospital[J]. Gastroenterol Hepatol,2018,41(9):544-552.

[36] CORPECHOT C,CARRAT F,POUPON R,et al. Primary biliary cirrhosis:Incidence and predictive factors of cirrhosis development in ursodiol-treated patients[J]. Gastroenterology,2002,122(3):652-658.

[37] HUET PM,VINCENT C,DESLAURIER J,et al. Portal hypertension and primary biliary cirrhosis:Effect of long-term ursodeoxycholic acid treatment[J]. Gastroenterology,2008,135(5):1552-1560.

[38] European Society of Gastrointestinal Endoscopy,European Association for the Study of the Liver,European Association for the Study of the Liver. Role of endoscopy in primary sclerosing cholangitis:European Society of Gastrointestinal Endoscopy(ESGE)and European Association for the Study of the Liver(EASL)clinical guideline[J]. J Hepatol,2017,66(6):1265-1281.

[39] GREGORIO GV,PORTMANN B,KARANI J,et al. Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood:A 16-year prospective study[J]. Hepatology,2001,33(3):544-553.

[40] KERKAR N,CHAN A. Autoimmune hepatitis,sclerosing cholangitis,and autoimmune sclerosing cholangitis or overlap syndrome[J]. Clin Liver Dis,2018,22(4):689-702.

[41] ABDO AA,BAIN VG,KICHIAN K,et al. Evolution of autoimmune hepatitis to primary sclerosing cholangitis:A sequential syndrome[J]. Hepatology,2002,36(6):1393-1399.

[42] TRIVEDI PJ,CHAPMAN RW. PSC,AIH and overlap syndrome in inflammatory bowel disease[J]. Clin Res Hepatol Gastroenterol,2012,36(5):420-436.

[43] TRIVEDI PJ,HIRSCHFIELD GM. Review article:Overlap syndromes and autoimmune liver disease[J]. Aliment Pharmacol Ther,2012,36(6):517-533.

[44] KAYA M,ANGULO P,LINDOR KD. Overlap of autoimmune hepatitis and primary sclerosing cholangitis:An evaluation of a modified scoring system[J]. J Hepatol,2000,33(4):537-542.

[45] van BUUREN HR,van HOOGSTRATEN H,TERKIVATAN T,et al. High prevalence of autoimmune hepatitis among patients with primary sclerosing cholangitis[J]. J Hepatol,2000,33(4):543-548.

[46] LINDOR KD,KOWDLEY KV,LUKETIC VA,et al. High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis[J]. Hepatology,2009,50(3):808-814.

[47] FICKERT P,HIRSCHFIELD GM,DENK G,et al. nor Ursodeoxycholic acid improves cholestasis in primary sclerosing cholangitis[J]. J Hepatol,2017,67(3):549-558.

[48] CHAPMAN R,FEVERY J,KALLOO A,et al. Diagnosis and management of primary sclerosing cholangitis[J]. Hepatology,2010,51(2):660-678.

[49] LTH S,KANZLER S,FRENZEL C,et al. Characteristics and long-term prognosis of the autoimmune hepatitis/primary sclerosing cholangitis overlap syndrome[J]. J Clin Gastroenterol,2009,43(1):75-80.

[50] FLOREANI A,RIZZOTTO ER,FERRARA F,et al. Clinical course and outcome of autoimmune hepatitis/primary sclerosing cholangitis overlap syndrome[J]. Am J Gastroenterol,2005,100(7):1516-1522.

[51] OLSSON R,GLAUMANN H,ALMER S,et al. High prevalence of small duct primary sclerosing cholangitis among patients with overlapping autoimmune hepatitis and primary sclerosing cholangitis[J]. Eur J Intern Med,2009,20(2):190-196.

[52] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Infectious Diseases,Chinese Medical Association. Consensus on the diagnosis and management of autoimmune hepatitis(2015)[J]. J Clin Hepatol,2016,32(1):9-22.(in Chinese)中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会．自身免疫性肝炎诊断和治疗共识(2015)[J]．临床肝胆病杂志，2016,32(1):9-22.

[53] MANDOLESI D,LENZI M,D'ERRICO A,et al. Primary biliary cholangitis-primary sclerosing cholangitis in an evolving overlap syndrome:A case report[J]. Gastroenterol Hepatol,2017,40(10):669-671.

[54] SUNDARAM S,S K,MAZUMDAR S,et al. Overlap syndrome between primary biliary cholangitis and primary sclerosing cholangitis[J]. ACG Case Rep J,2018,5:e54.

[55] KINGHAM JG,ABBASI A. Co-existence of primary biliary cirrhosis and primary sclerosing cholangitis:A rare overlap syndrome put in perspective[J]. Eur J Gastroenterol Hepatol,2005,17(10):1077-1080.

[56] STIEHL A. Ursodeoxycholic acid therapy in treatment of primary sclerosing cholangitis[J]. Scand J Gastroenterol Suppl,1994,204:59-61.

[57] CHAYANUPATKUL M,FIEL MI,SCHIANO TD. The clinical characteristics,pre-and post-liver transplantation outcomes in patients having autoimmune overlap syndromes[J].Clin Transplant,2020:e13841.

施引文献

资源附件(0)

访问统计