Clinical Presentation and Outcomes of Autoimmune Hepatitis in Inflammatory Bowel Disease

Anti-tumor necrosis factor (TNF)-α agents represent an effective treatment for chronic inflammatory diseases. However, some concerns about their potentially undesirable effects on liver function have been reported. On the other hand, evidence of their therapeutic effects on certain liver diseases is accumulating. Many data showed the safety of anti-TNF-α in patients with chronic hepatitis B and C and in liver transplanted patients even if a strict follow-up and prophylaxis are recommended in well-defined subgroups. On the other side, anti-TNF-α-induced liver injury is not a rare event. However, it is often reversible after anti-TNF-α withdrawal. Anti-TNF-α agents have been tested in advanced stages of severe alcoholic hepatitis and non-alcoholic fatty liver disease. Limited data on the efficacy of anti-TNF-α in patients with autoimmune hepatitis and primary biliary cholangitis are also available. In this review, we explored the hepatic safety concerns in patients receiving anti-TNF-α agents with and without pre-existent hepatic diseases. In addition, the available evidence on their potential benefits in the treatment of specific hepatic diseases is discussed.

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“…Nevertheless, caution should be used because of the risk of adverse effects, including cytopenia, opportunistic infections, and cancers [65]. …”

Section: Liver-transplanted Patientsmentioning

confidence: 99%

“…In this scenario, IFX is able to impair the pro-necrotic activity of activated lymphocytes. This could explain the observation of a better response to IFX in children with refractory AIH [65,144]. …”

Section: Potential Beneficial Effects Of Anti-tnf-α On Liver Diseasesmentioning

confidence: 99%

Harmful Effects and Potential Benefits of Anti-Tumor Necrosis Factor (TNF)-α on the Liver

Lopetuso

Mocci

Marzo

et al. 2018

IJMS

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“…In one adult study, AIH was associated with UC in 16% of the cases . Some experts suggest that IBD patients with co‐existence of AIH are more likely to relapse and progress to cirrhosis . The response to treatment of AIH is not affected by the presence of IBD …”

Section: Other Hepatic Manifestations Than Psc Affecting Ibd Patientsmentioning

confidence: 99%

Hepatic manifestations of inflammatory bowel diseases

Restellini

Chazouillères

Frossard

2016

Liver International

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Inflammatory bowel diseases are associated with various hepatobiliary disorders, reported both in Crohn's disease and ulcerative colitis. They may occur at any moment in the natural course of the disease. The prevalence of liver dysfunction rises from 3% to 50% accordingly to definitions used in different studies. Fatty liver is considered as the most common hepatobiliary complication in inflammatory bowel diseases while primary sclerosing cholangitis is the most specific one. Less frequently, inflammatory bowel diseases-associated hepatobiliary disorders include: autoimmune hepatitis/ primary sclerosing cholangitis overlap syndrome, IgG4-associated cholangiopathy, primary biliary cholangitis, hepatic amyloidosis, granulomatous hepatitis, cholelithiasis, portal vein thrombosis and liver abscess. The spectrum of these manifestations varies according to the type of inflammatory bowel diseases. Treatments of inflammatory bowel diseases may cause liver toxicity, although incidence of serious complications remains low. However, early diagnosis of drug-induced liver injury is of major importance as it affects future clinical management. When facing abnormal liver tests, clinicians should undertake a full diagnostic work-up in order to determine whether the hepatic abnormalities are related to the inflammatory bowel diseases or not.Management of hepatic manifestations in inflammatory bowel diseases usually involves both hepatologists and gastroenterologists because of the complexity of some situations. K E Y W O R D Sdrug-induced liver injury, hepatotoxicity, inflammatory bowel disease, liver disease, primary sclerosing cholangitis

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“…Both investigated oat beta-glucan fractions -low and high molecular weight -show antioxidative activity in the liver and stomach tissues which led to decrease of ROS products, 19 but high molecular weight beta-glucan seems to be more potent in vivo antioxidant, particularly in case of intestine inflammation. Moreover, it is absolutely obvious that different molecular weight of the same polymer -beta-glucan from oat exaggerates different molecular and metabolic activity.…”

Section: Discussionmentioning

confidence: 99%

“…There are many stomach and liver ailments observed in the course of IBDs, like focally enhanced gastritis, abnormal liver tests, autoimmune and granulomatous hepatitis, sclerosing cholangitis, cholangiopathy, biliary cirrhosis [15,16,17,18,19]. That indicates that these organs are highly susceptible to the 4 inflammatory process of the intestines.…”

Section: Introductionmentioning

confidence: 99%

Hepato- and gastro- protective activity of purified oat 1–3, 1–4-β- d -glucans of different molecular weight

Suchecka

Harasym

Wilczak

et al. 2016

International Journal of Biological Macromolecules

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Clinical Presentation and Outcomes of Autoimmune Hepatitis in Inflammatory Bowel Disease

Cited by 29 publications

References 78 publications

Harmful Effects and Potential Benefits of Anti-Tumor Necrosis Factor (TNF)-α on the Liver

Harmful Effects and Potential Benefits of Anti-Tumor Necrosis Factor (TNF)-α on the Liver

Hepatic manifestations of inflammatory bowel diseases

Hepato- and gastro- protective activity of purified oat 1–3, 1–4-β- d -glucans of different molecular weight

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