Low Serum Vitamin D Levels Are Associated with Severe Histological Features and Poor Response to Therapy in Patients with Autoimmune Hepatitis

Efe, Cumali; Kav, Taylan; Aydın, Çisel; Cengiz, Mustafa; Imga, Narin Nasiroglu; Pürnak, Tuğrul; Smyk, Daniel S.; Torğutalp, Murat; Turhan, Turan; Özeni̇rler, Seren; Özaslan, Ersan; Bogdanos, Dimitrios P.

doi:10.1007/s10620-014-3267-3

Cited by 82 publications

(73 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Polymorphisms in the VDR have been shown to increase susceptibility to certain autoimmune disorders, such as CD, type 1 diabetes, and inflammatory bowel diseases [34,35]. Furthermore, Vit D deficiency has been linked to a number of autoimmune disorders, including Crohn's disease, multiple sclerosis, AIH, PBC, psoriatic arthritis, and type 1 DM [36,37,38,39,40,41,42]. However, there are other studies that challenge these findings.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey

et al. 2015

View full text Add to dashboard Cite

Aim: To define the prevalence of polyautoimmunity (PAI) among celiac disease (CD) patients and to compare clinical and laboratory features of CD patients with or without PAI in order to determine the risk factors for PAI in CD. Material and Method: Patients diagnosed with CD in our clinic between 2007 and 2014 with at least 1 year of follow-up were retrospectively evaluated. Totally 145 patients were included in the study. Information on patient demographics and laboratory data were obtained from patient records. The study participants were divided into 2 groups. Group 1 was the CD-alone group consisting of patients without any other autoimmune diseases (AIDs), while group 2 was the PAI group consisting of patients with accompanying one or more AIDs. Results: The mean age of 145 CD patients (106 female and 39 male) included in the study was 37.2 ± 12.3 years. Of the 145 patients included, 48 (33.1%) were in the PAI group. When two groups were compared with each other in terms of the demographic features and laboratory data, the following were identified as risk factors for PAI: female gender, family history for AIDs, antigliadin IgG positivity, vitamin D deficiency, antinuclear antibody positivity ≥1/80 titer and having any musculoskeletal disease. Conclusion: To the best of our knowledge, this is one of the largest studies in the literature on CD patients for the PAI prevalence and related risk factors. Identification of the risk factors in early stages is important to explore PAI among CD patients. Larger, prospective studies are warranted about the risk factors and autoimmune characteristics of CD.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Low serum levels of 25-hydroxyvitamin D have been reported in diverse chronic liver diseases [314][315][316][317][318], including autoimmune hepatitis [319,320], and this deficiency has been associated with disease severity and hepatic fibrosis. Hepatic fibrosis scores and interface hepatitis are independently associated with vitamin D deficiency in autoimmune hepatitis, and the serum level of 25-hydroxyvitamin D may be a biomarker of the histological response to severe or protracted tissue damage [319]. It may also reflect the integrity of an interactive network of counter-regulatory mechanisms that modulate oxidative stress, inflammatory activity, and immune defense.…”

Section: Insights Into the Cytopathic Mechanisms Of Autoimmune Hepatitismentioning

confidence: 99%

Transitioning from Idiopathic to Explainable Autoimmune Hepatitis

Czaja

2015

Dig Dis Sci

View full text Add to dashboard Cite

Autoimmune hepatitis lacks an identifiable cause, and its diagnosis requires the exclusion of etiologically defined diseases that resemble it. Insights into its pathogenesis are moving autoimmune hepatitis from an idiopathic to explainable disease, and the goal of this review is to describe the insights that are hastening this transition. Two types of autoimmune hepatitis are justified by serological markers, but they also have distinctive genetic associations (DRB1 and DQB1 genes) and autoantigens. DRB1 alleles are the principal susceptibility factors in white adults, and a six amino acid sequence encoded in the antigen-binding groove of class II molecules of the major histocompatibility complex can influence the selection of autoantigens. Polymorphisms, including variants of SH2B3 and CARD10 genes, may affect immune reactivity and disease severity. The cytochrome mono-oxygenase, CYP2D6, is the autoantigen associated with type 2 autoimmune hepatitis, and it shares homologies with multiple viruses that might promote self-intolerance by molecular mimicry. Chemokines, especially CXCL9 and CXCL10, orchestrate the migration of effector cells to sites of injury and are associated with disease severity. Cells of the innate and adaptive immune responses promote tissue damage, and possible deficiencies in the number and function of regulatory T cells may facilitate the injurious process. Receptor-mediated apoptosis is the principal mechanism of hepatocyte loss, and cell-mediated and antibody-dependent mechanisms of cytotoxicity also contribute. Insights that explain autoimmune hepatitis will allow triggering exogenous antigens to be characterized, risk management to be improved, prognostic indices to be refined, and site-specific therapeutic interventions to emerge.

show abstract

“…After adjustment for the sampling timing, vitamin D deficiency was an independent factor associated with advanced liver fibrosis. Some studies have shown a correlation between vitamin D level and liver fibrosis 14,17,33. These studies were based on liver biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Grünhage et al 16. evaluated liver disease of various etiologies, and Efe et al 17. evaluated autoimmune liver disease, with regard to the inverse relationship between serum vitamin D level and liver fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease

Kim

et al. 2016

Gut and Liver

View full text Add to dashboard Cite

Background/AimsDeficiencies of 25-hydroxyvitamin D (25(OH)D) are prevalent in patients with chronic liver disease (CLD). Liver fibrosis is the main determinant of CLD prognosis. The present study was performed to evaluate the correlation between 25(OH)D levels and liver fibrosis as assessed by transient elastography (TE) in patients with compensated CLD.MethodsSerum 25(OH)D levels and liver stiffness were determined in a total of 207 patients who were subjected to the following exclusion criteria: patients with decompensated CLD; patients who had malignancies; patients who were taking medications; and patients who were pregnant.ResultsThe most common etiology was chronic hepatitis B (53.1%). Advanced liver fibrosis (defined by TE [≥9.5 kPa]) was present in 75 patients (36.2%). There was a significant correlation between 25(OH)D deficiency and liver stiffness. Based on the multivariate analysis, the following factors were independently associated with advanced liver fibrosis: 25(OH)D deficiency (odds ratio [OR], 3.46; p=0.004), diabetes mellitus (OR, 3.04; p=0.041), and fibrosis-4 index (OR, 2.01; p<0.001).ConclusionsPatients with compensated CLD exhibit a close correlation between vitamin D level and liver stiffness as assessed by TE. Vitamin D deficiency was independently associated with advanced liver fibrosis.

show abstract

Low Serum Vitamin D Levels Are Associated with Severe Histological Features and Poor Response to Therapy in Patients with Autoimmune Hepatitis

Abstract: Low 25(OH)D levels are associated with advance fibrosis and severe inflammation in AIH. Our study suggests that vitamin D may be a potential biomarker that predicts response to therapy and histological features in AIH.

Cited by 82 publications

References 19 publications

Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey

Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey

Transitioning from Idiopathic to Explainable Autoimmune Hepatitis

Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease

Contact Info

Product

Resources

About