Anti-Mitochondrial Antibody Titers Decrease Over Time in Primary Biliary Cholangitis Patients With Ursodeoxycholic Acid Therapeutic Response: A Cohort Study Followed Up to 28 Years

Chen, Wei‐Ting; Chan, Tien-Ming; Lin, Cheng‐Yu; Chang, Ming‐Ling; Chen, Shiang-Chi; Chien, Rong‐Nan

doi:10.3389/fimmu.2022.869018

Cited by 7 publications

(6 citation statements)

References 38 publications

(50 reference statements)

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“…[14] In a 28-year cohort study, UDCA responders exhibited decreased AMA IgG titers at 1 year after treatment, which persisted until the last follow-up. [10] Our study also found that AMA was independently associated with the development of cirrhosis in PBC patients. Additionally, higher AMA titers were linked to an increased risk of developing liver cirrhosis.…”

Section: Discussionsupporting

confidence: 73%

“…[7] Nevertheless, accumulating evidence suggests that AMA titers may be associated with the outcome of PBC patients. [8][9][10] Currently, there is still controversy regarding the relationship between AMA and prognosis for PBC patients. Accordingly, we conducted a retrospective study to investigate the association between AMA and liver cirrhosis in PBC patients and to establish the relationship between AMA and different stages of liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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Antimitochondrial antibody associated with liver cirrhosis in patients with primary biliary cholangitis

Jin,

Wang,

Liu

et al. 2023

Medicine

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Antimitochondrial antibody (AMA) serves as a serological marker for diagnosing primary biliary cholangitis (PBC). However, the association between AMA and prognosis for PBC patients remains unclear. The objective of this study was to investigate the relationship between AMA and cirrhosis in PBC patients. This retrospective study enrolled 225 PBC patients, including 127 with liver cirrhosis and 98 without cirrhosis. AMA was tested by indirect immunofluorescence (IIF) with rat kidney as the substrate. AMA-M2 and M2-3E were detected by line immunoassay (LIA). The overall positivity rate for AMA detection in PBC patients was 80.9%. The positivity rates of IIF-AMA, AMA-M2, and M2-3E were significantly higher in patients with liver cirrhosis than in those without cirrhosis (73.2% vs. 52.0%, 74.0% vs. 51.0%, and 80.3% vs. 60.2%, respectively). In multivariate logistic regression, IIF-AMA (OR: 3.05, 95% CI: 1.59–5.87), AMA-M2 (OR: 3.11, 95% CI: 1.61–6.01), and M2-3E (OR: 3.29, 95% CI: 1.63–6.66) remained significantly associated with an increased incidence of liver cirrhosis. Moreover, in multinomial logistic regression, IIF-AMA (compensated cirrhosis, OR: 3.55, 95% CI: 1.49–8.44; decompensated cirrhosis, OR: 2.86, 95% CI: 1.32–6.18), AMA-M2 (compensated cirrhosis, OR: 4.74, 95% CI: 1.94–11.58; decompensated cirrhosis, OR: 2.51, 95% CI: 1.19–5.33), and M2-3E (compensated cirrhosis, OR: 4.92, 95% CI: 1.74–13.96; decompensated cirrhosis, OR: 2.91, 95% CI: 1.28–6.64) were all found to be associated with different stages of liver cirrhosis. AMA was found to be associated with the occurrence of liver cirrhosis in PBC patients. Additionally, AMA was also related to different stages of liver cirrhosis, including compensated and decompensated cirrhosis.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Antimitochondrial antibody associated with liver cirrhosis in patients with primary biliary cholangitis

Jin,

Wang,

Liu

et al. 2023

Medicine

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“…First, patients with mild PBC might not have been enrolled due to lack of alertness of clinicians to register them with the ICD‐9 code. Second, the fact that the TNHIRD did not contain clinical findings, direct laboratory results, or pathological results 60 . and that UDCA is not specific for PBC treatment, might have biased the data to some extent.…”

Section: Discussionmentioning

confidence: 99%

“…Second, the fact that the TNHIRD did not contain clinical findings, direct laboratory results, or pathological results. 60 and that UDCA is not specific for PBC treatment, might have biased the data to some extent. Third, the PBC rates might have been underestimated, as patients with HBV or HCV infection had been eliminated.…”

Section: Countries/regionsmentioning

confidence: 99%

Characteristic geoepidemiology of primary biliary cholangitis in Taiwan: A nationwide population‐based study

Cheng

Chen

et al. 2023

Hepatology Research

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AimData on the geoepidemiology and outcomes of primary biliary cholangitis (PBC) in Asia are limited; thus, we aimed to collect and assess this information for Taiwan.MethodsA nationwide population‐based cohort study was undertaken using data from the Taiwan National Health Insurance Research Database. Primary biliary cholangitis was defined by the International Classification of Diseases, Ninth Revision, Clinical Modification code 571.6 based on alkaline phosphatase and antimitochondrial antibody measurements and ursodeoxycholic acid treatment.ResultsDuring 2002–2015, 2737 patients (2137 female patients; mean age, 57.78 years) had PBC. The average annual age‐ and sex‐adjusted prevalence and incidence rates of PBC were 8.092/105 and 1.148/105, respectively. Prevalent cases peaked in patients aged 50–59 years; the female‐to‐male ratio was 4.21. Annual prevalence rates increased with time (average percentage change, 12.03%; p < 0.0001). The annual incidence rates decreased with time (−7.39%; p = 0.000011) in female patients (−8.94%; p = 0.000003) but remained steady in male patients. Female‐to‐male and northern‐to‐southern relative risks of PBC incidence rates ranged from 2.2675 to 4.3318 and from 1.5707 to 3.1725, respectively. The 14‐year hepatocellular carcinoma (HCC) cumulative incidence was 9.11%, and the mortality rate was 32.44%; the cumulative incidences of dyslipidemia, thyroid disease, and extrahepatic cancers were 65.13%, 24.40%, and 12.79%, respectively. Higher cumulative incidences of HCC (p = 0.0064) and mortality (p < 0.0001) were noted in male than female PBC patients; southern Taiwan PBC patients had higher cumulative incidences of mortality (p < 0.0001) than their northern counterparts.ConclusionIn Taiwan, decreasing trends in incidence rates and the female‐to‐male ratio of PBC patients and specific sex and geographic impacts on the incidence rates and outcomes of PBC demand further investigation.

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“…Moreover, how AMA titers vary according to therapy remains a largely unexplored field, with the only evidence available coming from primary biliary cholangitis: an Asian cohort demonstrated that a decrease of AMA titers was noticed in patients responding to ursodeoxycholic acid therapy, but not in non-responders. 142 …”

Section: Treatmentmentioning

confidence: 99%

The Emerging Role of Mitochondrial Dysfunction in the Pathogenesis of Idiopathic Inflammatory Myopathies

Gonzalez-Chapa¹,

Macêdo²,

Lood³

2023

Rambam Maimonides Med J

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Increasing evidence points towards mitochondria as crucial players in the initiation and progression of auto-immune and degenerative disorders, to which impaired cell metabolism is but a facet of the subjacent etiopathogenesis. This review aims to introduce the reader to essential concepts of mitochondrial abnormalities in idiopathic inflammatory myopathy (IIM), underscoring inclusion-body myositis and dermatomyositis. Far surpassing the initial simplistic view of being responsible for energy generation, mitochondria have gathered attention regarding their role in inflammatory processes, being able to fuel autoimmunity, as shown by the presence of anti-mitochondrial antibodies (AMAs) in up to 10% of IIM patients. As cellular respiration takes place, mitochondrial metabolites might help to shape the pro-inflammatory milieu in affected muscle, beyond generating reactive oxygen species, which are well-recognized inducers of damage-associated molecular patterns. A series of mitochondrial components might facilitate the sterile activation of pro-inflammatory cells and the production of several cytokines responsible for enhancing auto-immune responses. Marked variation in the mitochondrial genome has also been reported in IIM patients. As such, we summarize key historical and recent advances linking aberrations and instabilities of mitochondrial DNA to impaired muscle function. Besides discussing mitochondrial dysfunction as an essential part of IIM development, we also highlight possible associations between presence of AMAs and a particular phenotype of IIM, with its own characteristic clinical and radiological pattern. Finally, we present promising treatment approaches targeting mitochondria, while briefly discussing experimental models for gaining deeper insight into the disease process, and ultimately leading to novel drug development.

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Anti-Mitochondrial Antibody Titers Decrease Over Time in Primary Biliary Cholangitis Patients With Ursodeoxycholic Acid Therapeutic Response: A Cohort Study Followed Up to 28 Years

Cited by 7 publications

References 38 publications

Antimitochondrial antibody associated with liver cirrhosis in patients with primary biliary cholangitis

Antimitochondrial antibody associated with liver cirrhosis in patients with primary biliary cholangitis

Characteristic geoepidemiology of primary biliary cholangitis in Taiwan: A nationwide population‐based study

The Emerging Role of Mitochondrial Dysfunction in the Pathogenesis of Idiopathic Inflammatory Myopathies

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