Smoking as a risk factor for autoimmune liver disease: What we can learn from primary biliary cirrhosis
Primary biliary cirrhosis (PBC) is a cholestatic liver disease characterised by the immune-mediated destruction of biliary epithelial cells in small intrahepatic bile ducts. The disease is characterised by circulating anti-mitochondrial antibodies (AMA) as well as disease specific anti-nuclear antibodies (ANA), cholestatic liver biochemistry, and characteristic histology. The disease primarily affects middle-aged females, and its incidence is apparently increasing worldwide. Epidemiological studies have indicated several risk factors for the development of PBC, with family history of PBC, recurrent urinary tract infection, and smoking being the most widely cited. Smoking has been implicated as a risk factor in several autoimmune diseases, including the liver, by complex mechanisms involving the endocrine and immunological systems to name a few. Studies of smoking in liver disease have also shown that smoking may progress the disease towards fibrosis and subsequent cirrhosis. This review will examine the literature surrounding smoking as a risk factor for PBC, as well as a potential factor in the progression of fibrosis in PBC patients.
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Kelekis, N. L.; Makri, E.; Vassiou, A.; Patsiaoura, K.; Spiridakis, M.; Dalekos, G. N. (2004)Confluent hepatic fibrosis (CHF) is usually a feature of advanced cirrhosis, while occurrence in early stage compensated cirrhosis is uncommon. We report the imaging findings of masslike CHF in a patient with previously ...
Multiple viral/self immunological cross-reactivity in liver kidney microsomal antibody positive hepatitis C virus-infected patients is associated with the possession of HLA B51 Bogdanos, D. P.; Lenzi, M.; Okamoto, M.; Rigopoulou, E. I.; Muratori, P.; Ma, Y.; Muratori, L.; Tsantoulas, D.; Mieli-Vergani, G.; Bianchi, F. B.; Vergani, D. (2004)Liver Kidney Microsomal autoantibody type 1(LKM1) directed to cytochrome P4502D6 (CYP2D6) characterises autoimmune hepatitis type-2 (AIH-2), but is also found in a proportion of chronic hepatitis C virus (HCV) infected ...
Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler: Art of facts or an artifact? Zellos, A.; Spoulou, V.; Roma-Giannikou, E.; Karentzou, O.; Dalekos, G. N.; Theodoridou, M. (2013)Epstein-Barr virus (EBV) can cause frequently asymptomatic (or anicteric) and self-limited hepatitis, while occasionally may result in considerable cholestatic hepatitis. Herein, we describe the case of a previously healthy ...