Commensal Flora, is it an Unwelcomed Companion as a Triggering Factor of Autoimmune Pancreatitis?

Haruta, Ikuko; Shimizu, Kyoko; Yanagisawa, Naoko; Shiratori, Keiko; Yagi, Junji

doi:10.3389/fphys.2012.00077

Cited by 13 publications

(7 citation statements)

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“…The complex ecosystem of the intestinal microbiota influences numerous functions, and overall health and any disruptions of the interaction with the local immune system can lead to gastrointestinal disease . Current studies raise the possibility that enteric bacteria are related to immune‐mediated cholangitis and pancreatitis . Overall, an autoimmune process might be the underlying cause of triaditis in cats …”

Section: Discussionmentioning

confidence: 99%

Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats

Fragkou

Adαmama-Moraitou

Poutahidis

et al. 2016

Veterinary Internal Medicne

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BackgroundThe term triaditis designates the concurrent presence of idiopathic inflammatory bowel disease (IBD), cholangitis, and pancreatitis in cats.Hypothesis/ObjectivesThe histopathology of concurrent, but often subclinical, inflammatory processes in the small intestine, liver, and pancreas of cats is poorly described. We aimed to investigate the frequency of enteritis, cholangitis, pancreatitis, or some combination of these in symptomatic and asymptomatic cats, compare clinicopathological features, and correlate histopathological with laboratory findings.AnimalsDomestic cats (27 symptomatic, 20 asymptomatic, and 8 normal).MethodsProspective study. Physical examination, laboratory variables (CBC, serum biochemistry profile, serum thyroxine concentration, serum feline trypsin‐like immunoreactivity [fTLI], feline lipase immunoreactivity [fPLI, as measured by Spec fPL ®], urinalysis, and fecal analysis), imaging, and histopathological examinations were conducted. Feline liver, pancreas, and small intestine were biopsied during laparotomy.ResultsInflammatory lesions were detected in 47 cats (27 symptomatic, 20 asymptomatic). In total, 20 cats had histopathologic lesions of IBD (13/47, 27.7%), cholangitis (6/47, 12.8%), or pancreatitis (1/47, 2.1%) alone, or inflammation involving >1 organ (27/47, 57.4%). More specifically, 16/47 cats (34.0%) had concurrent lesions of IBD and cholangitis, 3/47 (6.4%) of IBD and pancreatitis, and 8/47 cats (17%) of triaditis. Triaditis was identified only in symptomatic cats (8/27, 29.6%). A mild, positive correlation was detected between the severity (score) of IBD lesions and the number of comorbidities (rho = +0.367, P = .022).Conclusions and Clinical ImportanceHistopathological evidence of IBD or IBD with comorbidities was detected in both symptomatic and asymptomatic cats. The possibility of triaditis should be considered in symptomatic cats with severe IBD.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats

Fragkou

Adαmama-Moraitou

Poutahidis

et al. 2016

Veterinary Internal Medicne

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“…In humans and experimental animals, autoimmune pancreatitis and cholangitis are recognised as extra‐intestinal complications of IBD, with immune attack frequently directed against bile and pancreatic ducts (Navaneethan & Shen , Yanagisawa et al , ). Immune‐mediated damage is typically considered a consequence of immune responses against bacteria (that may or may not have established an active infection) that cross‐react with host tissues with resultant innocent by‐stander immune responses in the intestines, liver and pancreas, or immune attack against host antigens unmasked by tissue damage (Haruta et al ). Several experimental studies support the possibility that immune responses to enteric bacteria are related to immune‐mediated pancreatitis and cholangitis.…”

Section: How Is Pancreatitis Related To Triaditis?mentioning

confidence: 99%

Pancreatitis and triaditis in cats: causes and treatment

Simpson

2015

J of Small Animal Practice

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Pancreatitis in cats is frequently accompanied by concurrent disease in other organ systems. Co‐morbidities include hepatic lipidosis, inflammatory liver disease, bile duct obstruction, diabetes mellitus, inflammatory bowel disease, vitamin deficiency (B12/cobalamin, folate or K), intestinal lymphoma, nephritis, pulmonary thromboembolism and pleural and peritoneal effusions. “Triaditis” is the term used to describe concurrent inflammation of the pancreas, liver and small intestines. Triaditis has been reported in 50 to 56% of cats diagnosed with pancreatitis and 32 to 50% of those with cholangitis/inflammatory liver disease. A definitive diagnosis of triaditis is based on the histopathological evaluation of each organ. However, the specific conditions of each organ that constitute a diagnosis of triaditis remains to be defined. While the aetiopathogenesis of pancreatitis and its relationship to inflammation in other organ systems is unclear, preliminary studies point to a heterogeneous group of conditions with differential involvement of host inflammatory and immune responses and enteric bacteria. Comprehensive, prospective studies that simultaneously evaluate the presence of predefined clinical, clinicopathological and histopathological abnormalities, coupled with high‐resolution evaluation of pancreaticobiliary morphology, immunological profiling and screening for bacterial colonisation are required to advance diagnosis and therapy.

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“…Animal models of AIP have been developed by exposing C57BL/6 mice to heat-killed Escherichia coli to produce marked cellular infiltration with fibrosis in the exocrine pancreas and salivary glands (74) . One representative antigen reacting with the serum of E. coli -inoculated mice was FliC (75) .…”

Section: Immunological Abnormalities In Igg4-rdmentioning

confidence: 99%

Immunoglobulin G4-related Disease: An Overview

2019

JMA J

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Immunoglobulin G4-related disease (IgG4-RD) is a recently established systemic disease that is characteristically associated with elevated serum immunoglobulin G4 (IgG4) levels and believed to be caused by autoimmune mechanisms. The clinical features of IgG4-RD include (i) systemic distribution, (ii) imaging findings of swelling, nodules, and/or wall thickening, (iii) high serum IgG4 levels, (iv) abundant IgG4-bearing plasma cell infiltration and fibrosis in affected organs, (v) a favorable response to corticosteroid therapy, and (vi) coexistence with other IgG4-RD manifestations simultaneously or in a metachronous fashion. The concept of IgG4-RD was established based on the culmination of specific discoveries. Specifically, a close association between autoimmune pancreatitis (AIP) and high serum IgG4 levels, massive IgG4-bearing plasma cell infiltration in pancreatic tissues affected by AIP, and systemic other organ involvements in AIP with similar IgG4-bearing plasma cell features opened the gateway from AIP to IgG4-RD. The systemic distribution of IgG4-RD seems to be capable of affecting every organ, causing well-established members including AIP, lacrimal and salivary gland lesions such as Mikulicz’s disease, respiratory diseases, sclerosing cholangitis, kidney diseases, and retroperitoneal fibrosis. IgG4-RD has been diagnosed worldwide, and international collaboration efforts on the disease have led to consensus publications on its nomenclature, pathology findings, and management approach. The algorithms developed for the comprehensive diagnostic criteria for IgG4-RD have remarkably increased detection sensitivity. Oral glucocorticoids are the first-line agents for remission induction, and certain patients with high disease activity may benefit from maintenance therapy afterwards. Originally, IgG4-RD had been considered reversible and to have a good prognosis; however, long-term afflictions sometimes result in transition to advanced-stage conditions with dysfunction and/or complicating malignancy. The immunological abnormalities in IgG4-RD have been reported in both innate and adaptive immune systems; however, it remains unclear whether IgG4 has a pathogenic role or a protective one in disease onset and progression.

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Commensal Flora, is it an Unwelcomed Companion as a Triggering Factor of Autoimmune Pancreatitis?

Cited by 13 publications

References 75 publications

Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats

Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats

Pancreatitis and triaditis in cats: causes and treatment

Immunoglobulin G4-related Disease: An Overview

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