Review of Diagnostic Biomarkers in Autoimmune Pancreatitis: Where Are We Now?

Yokode, Masayuki; Shiokawa, Masahiro; Kodama, Yuzo

doi:10.3390/diagnostics11050770

Cited by 11 publications

(6 citation statements)

References 68 publications

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“…Similarly, elevated serum IgG4 levels in non‐AIP pancreatic disease and pancreatic cancer can also be found and decrease after steroid therapy in these diseases 11 . Due to the limitation of serum IgG4 levels as a disease activity marker in some cases of IgG4‐RD, other biomarkers such as interferon‐α and interleukin‐33 have been newly introduced as diagnostic and disease activity markers 28,29 . Meanwhile, abnormal liver function test results are not specific for the detection of the occurrence or relapse of IgG4‐SC, because other etiologies or medical problems also can contribute to liver function abnormalities without biliary stricture.…”

Section: Discussionmentioning

confidence: 99%

“…11 Due to the limitation of serum IgG4 levels as a disease activity marker in some cases of IgG4-RD, other biomarkers such as interferon-α and interleukin-33 have been newly introduced as diagnostic and disease activity markers. 28,29 Meanwhile, abnormal liver function test results are not specific for the detection of the occurrence or relapse of IgG4-SC, because other etiologies or medical problems also can contribute to liver function abnormalities without biliary stricture. Although IgG4-SC is a steroid-responsive disease, relapses frequently occur during follow-up similar to other forms of IgG4-RD.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the long‐term outcomes between proximal and distal IgG4‐related sclerosing cholangitis: A multicenter cohort study

Cho

Song

Park

et al. 2023

J of Gastro and Hepatol

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Background and Aims: Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is considered a biliary manifestation of IgG4-related diseases. However, there has been a controversy on the clinical outcomes according to the location of the involved bile duct. We therefore compared the clinical outcomes and long-term prognosis of IgG4-SC with proximal bile duct involvement (proximal IgG4-SC) and IgG4-SC with distal bile duct involvement (distal IgG4-SC). Methods: We reviewed the data of patients with IgG4-SC that were prospectively collected at 10 tertiary centers between March 2002 and October 2020. Clinical manifestations, outcomes, association with autoimmune pancreatitis (AIP), steroid-responsiveness, and relapse of IgG4-SC were evaluated. Results: A total of 148 patients (proximal IgG4-SC, n = 59; distal IgG4-SC, n = 89) were analyzed. The median age was 65 years (IQR, 56.25-71), and 86% were male. The two groups were similar in terms of jaundice at initial presentation (51% vs 65%; P = 0.082) and presence of elevated serum IgG4 (66% vs 70%; P = 0.649). The two groups showed significant differences in terms of steroid-responsiveness (91% vs 100%; P = 0.008), association with AIP (75% vs 99%; P = 0.001), and occurrence of liver cirrhosis (9% vs 1%; P = 0.034). During a median follow-up of 64 months (IQR, 21.9-84.7), the cumulative relapse-free survival was significantly different between the two groups (67% vs 79% at 5 years; P = 0.035). Conclusions: Relapse of IgG4-SC frequently occurred during follow-up. Proximal IgG4-SC and distal IgG4-SC had different long-term outcomes in terms of steroidresponsiveness, occurrence of liver cirrhosis, and recurrence. It may be advantageous to determine the therapeutic and follow-up strategies according to the location of bile duct involvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of the long‐term outcomes between proximal and distal IgG4‐related sclerosing cholangitis: A multicenter cohort study

Cho

Song

Park

et al. 2023

J of Gastro and Hepatol

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“…It demonstrates features in the pancreatic ducts resembling granulocytic epithelial lesions. Type 1 AIP also acts as a pancreatic lesion related to IgG4-related disease[ 13 ]. Since both type I AIP and type II AIP are based on identification using non-invasive approaches, the development of these techniques is urgent to support cases where invasive approaches are a less viable option.…”

Section: Liquid Biopsy and Its Role In Panca Diagnosismentioning

confidence: 99%

“…Since both type I AIP and type II AIP are based on identification using non-invasive approaches, the development of these techniques is urgent to support cases where invasive approaches are a less viable option. This approach acts as a powerful alternative to existing diagnostic methods and will be highly beneficial for the identification of cases with aggressive tumor biology and support clinicians to make proper individualized targeted therapy[ 13 - 17 ].…”

Section: Liquid Biopsy and Its Role In Panca Diagnosismentioning

confidence: 99%

Emerging role of non-invasive and liquid biopsy biomarkers in pancreatic cancer

Bararia¹,

Chakraborty²,

Roy³

et al. 2023

World J Gastroenterol

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A global increase in the incidence of pancreatic cancer (PanCa) presents a major concern and health burden. The traditional tissue-based diagnostic techniques provided a major way forward for molecular diagnostics; however, they face limitations based on diagnosis-associated difficulties and concerns surrounding tissue availability in the clinical setting. Late disease development with asymptomatic behavior is a drawback in the case of existing diagnostic procedures. The capability of cell free markers in discriminating PanCa from autoimmune pancreatitis and chronic pancreatitis along with other precancerous lesions can be a boon to clinicians. Early-stage diagnosis of PanCa can be achieved only if these biomarkers specifically discriminate the non-carcinogenic disease stage from malignancy with respect to tumor stages. In this review, we comprehensively described the non-invasive disease detection approaches and why these approaches are gaining popularity for their early-stage diagnostic capability and associated clinical feasibility.

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“…Serological biomarkers can potentially aid in definitive diagnosis and should be measured if IgG4-related gastrointestinal disease is suspected [ 18 ]. However, no specific biomarkers for AIP have been identified to date [ 19 ]. Serum IgG4 levels lack the sensitivity and specificity to establish a diagnosis of AIP or to distinguish it from other diseases such as primary sclerosing cholangitis, pancreatic cancer, and other hepatopancreatobiliary diseases [ 20 , 21 ].…”

Section: Autoimmune Pancreatitis As a Diagnostic Challengementioning

confidence: 99%

Is Surgery in Autoimmune Pancreatitis Always a Failure?

Zavrtanik

Tomažič

2023

Medicina

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Autoimmune pancreatitis is a rare form of chronic pancreatitis of presumed autoimmune etiology. Due to significant overlap in clinical and imaging characteristics, misdiagnosis as a pancreatic malignancy is common. As a result, a significant number of patients undergo a major pancreatic resection, associated with considerable morbidity, for a disease process that generally responds well to corticosteroid therapy. In the past ten years, important advances have been made in understanding the disease. Several diagnostic criteria have been developed to aid in diagnosis. Despite this, pancreatic resection may still be required in a subset of patients to reliably exclude pancreatic malignancy and establish a definite diagnosis of autoimmune pancreatitis. This article aimed to define the role of surgery in autoimmune pancreatitis, if any. For this purpose, published case series of patients with a diagnosis of autoimmune pancreatitis, based on the histopathological examination of surgical specimens, were reviewed and patients’ clinical, radiological and serological details were assessed. At the end, histopathologic examinations of patients who underwent pancreatic resection at our department in the last 10 years were retrospectively reviewed in order to identify patients with autoimmune pancreatitis and assess their clinical characteristics.

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Review of Diagnostic Biomarkers in Autoimmune Pancreatitis: Where Are We Now?

Cited by 11 publications

References 68 publications

Comparison of the long‐term outcomes between proximal and distal IgG4‐related sclerosing cholangitis: A multicenter cohort study

Comparison of the long‐term outcomes between proximal and distal IgG4‐related sclerosing cholangitis: A multicenter cohort study

Emerging role of non-invasive and liquid biopsy biomarkers in pancreatic cancer

Is Surgery in Autoimmune Pancreatitis Always a Failure?

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