Prevalence and impact of Sjögren's syndrome in primary biliary cholangitis: a systematic review and meta-analysis

Deng, Xiaoling; Hou, Shuhui; Ci, Bai; Liu, Beibei; Xu, Kang

doi:10.1016/j.aohep.2022.100746

Cited by 17 publications

(16 citation statements)

References 25 publications

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“…T cell-mediated immunity downregulation after long-period usage of immunosuppressive regimen could contribute to the development of caries, but speci c to the process of transplantation therapy instead of the progress of liver condition. (19) Sjögren's syndrome is an immune-mediated disease common in people with chronic hepatobiliary diseases, (47,48) in which saliva reduction followed by a decrease in salivary proteins and acid buffering capacity could lower the oral prevention of bacteria and carbohydrates. Actually, active caries patients were more related to xerostomia, lower salivary ow rate and worse oral and general health conditions.…”

Section: Discussionmentioning

confidence: 99%

The mutual effect of dental caries on NAFLD and liver fibrosis: Results from the NHANES and MR study

Huang,

Wang,

Wang

et al. 2024

Preprint

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Background & Aims: Dental caries and non-alcoholic fatty liver disease (NAFLD) overlap in risk factors and etiology, but the relationship remains unexplored.. Methods 6650 participants of the National Health and Nutrition Examination Survey (NHANES), 2017–2020 were included. Two multivariable logistic regression models were employed to evaluate the relationship among untreated dental caries (UDC) and liver conditions of NAFLD and fibrosis, with adjustments for demographics, lifestyle and medical history. Further more, two-sample Mendelian randomization (MR) was performed with caries as exposure and NAFLD with NAFLD-related conditions as outcome, and vice versa for bidirectional causality validation. Results In the observational research, UDCs were notably associated with NAFLD (OR: 1.40, 95% CI: 1.06–1.86) and significant fibrosis (SF) (OR: 1.29, 95% CI: 1.03–1.62). NAFLD and SF showed significant associations with UDCs (OR: 1.40, 95% CI: 1.08–1.83; OR: 1.62, 95% CI: 1.26–2.08). In MR analysis, dental caries had an insignificant risk towards liver conditions. In contrast, caries were insignificantly protected by liver conditions. Conclusions Observational studies suggested a significant association between UDC and liver conditions of NAFLD and fibrosis. However, MR suggested an insignificant causal relationship of caries with liver conditions; reversely, liver conditions had a protective effect on caries.

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Section: Discussionmentioning

confidence: 99%

The mutual effect of dental caries on NAFLD and liver fibrosis: Results from the NHANES and MR study

Huang,

Wang,

Wang

et al. 2024

Preprint

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“…Only one study 45 involving 51 PBC patients and 102 healthy individuals examined vitamin B6, B9, B12, and Hcy together. In the study of Biagini et al, 45 compared with the control group, vitamin B6 and B9 were significantly decreased in patients with PBC (vitamin B6: 6.6 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] vs. 10.0 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] pg/mL, p < .001; vitamin B9: 5.3 [1.2-13.4] vs. 10.7 [5.4-18.5] ng/mL, p < .001), while serum vitamin B12 levels were significantly elevated in them (335 [201-977] vs. 304.9 [176-427.1] pg/mL, p < .05). For Hcy, the content of its fasting state in plasma was also significantly higher in patients than in controls (12.1 ± 8.76 [1.5-58.8] vs. 9.9 ± 1.7 [6.4-18.0] µmol/L, p < .001).…”

Section: Vitamin B6 B9 B12 and Hcymentioning

confidence: 94%

“…4,5 In addition, AILD is often accompanied by autoimmune diseases of other systems, like inflammatory bowel disease, Sjogren's syndrome. 6,7 Therefore, AILD has become a serious chronic liver disease, causing huge economic burden to the society. 4,5,8 AILD may occur due to genetic predisposition, environmental factors (smoking, drug, and xenobiotic exposure, various hepatitis virus infections), loss of immune tolerance to self-antigens, immune disorders, as well as alterations of commensal intestinal flora.…”

Section: Introductionmentioning

confidence: 99%

“…But, up to 40% of AILDs inevitably recur after liver transplantation despite preoperative immunosuppressive therapy 4,5 . In addition, AILD is often accompanied by autoimmune diseases of other systems, like inflammatory bowel disease, Sjogren's syndrome 6,7 . Therefore, AILD has become a serious chronic liver disease, causing huge economic burden to the society 4,5,8 …”

Section: Introductionmentioning

confidence: 99%

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Serum vitamins and homocysteine levels in autoimmune liver disease: A systematic review and meta‐analysis

Li,

Tian,

et al. 2024

Immunity Inflam & Disease

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ObjectiveVitamins and homocysteine (Hcy) are involved in liver metabolism and related to the pathogenesis of autoimmune liver disease (AILD), but consensus is lacking. This study aims to systematically summarize relevant evidence to clarify the association of serum vitamins and Hcy levels with AILD.MethodsThe English and Chinese literature was searched until August 29, 2023. Studies were included if they were observational studies of investigating serum vitamins and Hcy levels in patients with AILD and their healthy comparisons. Quality assessment was performed by using the Newcastle–Ottawa Scale, and a meta‐analysis was conducted using ReviewManager 5.3. The protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42023455367.ResultsA total of 25 case–control studies comprising 3487 patients (1673 patients and 1814 healthy controls) were included for analysis. There were 548 autoimmune hepatitis (AIH) cases, 1106 primary biliary cholangitis (PBC) cases, and 19 primary sclerosing cholangitis (PSC) cases. We found that serum A and E were decreased in both AIH and PBC/PSC; but vitamin C was reduced only in patients with PBC, not AIH. In addition, decreased content of 25(OH)D3 was found in both AIH and PBC. However, levels of 25(OH)D did not differ between the patients and controls, and were independent of disease types and the country. Only one study that met the inclusion criteria reported vitamin B6, B9, B12, and Hcy changes, and found that vitamin B6 and B9 were significantly decreased in patients with PBC, while serum vitamin B12 and Hcy levels were significantly elevated in them. One eligible study each confirmed a reduction in plasma vitamin K1 and 1,25(OH)2D3 in patients with PBC.ConclusionMost vitamins are deficient in AILD, so appropriate vitamin supplementation should be necessary. Further studies with larger sample sizes are needed to validate these findings.

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“…Quality of life in PBC patients can be severely altered by pruritus, fatigue, and Sjögren’s syndrome, i.e., sicca syndrome that may be persistent and intense even in the early disease stage. Noteworthily, symptoms do not correlate with the disease course severity, but are related to its duration, About 40% of PBC patients suffer from skin complaints that include not only dry skin but also jaundice, hyperpigmentation, xanthelasma, xanthomas, and dermatographism [ 9 , 10 ]. Metabolic bone disease in PBC patients can develop as a result of reduced absorption of fat-soluble vitamins, i.e., vitamin D deficiency, and therefore they should be monitored and treated if required.…”

Section: Clinical Characteristics Of Pbc and Pscmentioning

confidence: 99%

Selected Aspects of the Intricate Background of Immune-Related Cholangiopathies—A Critical Overview

Kasztelan-Szczerbińska

Rycyk-Bojarzynska

Szczerbinska

et al. 2023

Nutrients

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Primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) are rare immune-related cholangiopathies with still poorly explained pathogenesis. Although triggers of chronic inflammation with subsequent fibrosis that affect cholangiocytes leading to obliteration of bile ducts and conversion to liver cirrhosis are unclear, both disorders are regarded to be multifactorial. Different factors can contribute to the development of hepatocellular injury in the course of progressive cholestasis, including (1) body accumulation of bile acids and their toxicity, (2) decreased food intake and nutrient absorption, (3) gut microbiota transformation, and (4) reorganized host metabolism. Growing evidence suggests that intestinal microbiome composition not only can be altered by liver dysfunction, but in turn, it actively impacts hepatic conditions. In this review, we highlight the role of key factors such as the gut–liver axis, intestinal barrier integrity, bile acid synthesis and circulation, and microbiome composition, which seem to be strongly related to PBC and PSC outcome. Emerging treatments and future therapeutic strategies are also presented.

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Prevalence and impact of Sjögren's syndrome in primary biliary cholangitis: a systematic review and meta-analysis

Cited by 17 publications

References 25 publications

The mutual effect of dental caries on NAFLD and liver fibrosis: Results from the NHANES and MR study

The mutual effect of dental caries on NAFLD and liver fibrosis: Results from the NHANES and MR study

Serum vitamins and homocysteine levels in autoimmune liver disease: A systematic review and meta‐analysis

Selected Aspects of the Intricate Background of Immune-Related Cholangiopathies—A Critical Overview

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