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自身免疫性胃炎和自身免疫性肝病之间的免疫学和临床重叠:一个前性队列研究
Sara Massironi1, Giulia Dispinzieri2,3, Alberto Rossi2
1Vita e Salute San Raffaele University, Medicine and Surgery, Milan, Italy.
Frontiers in immunology
|August 11, 2025
概括
自免疫性胃炎 (AIG) 在患有自身免疫性肝病 (AILDs) 的患者中很常见,特别是初级胆道胆炎. 查AILD患者的AIG可能会改善早期检测和相关胃病的管理.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 自身免疫性胃炎 (AIG) 和自身免疫性肝病 (AILD) 是一种慢性免疫媒介疾病.
- AIG和AILD (AIH,PBC,PSC) 之间的共同发生和特定关联尚未得到充分理解.
- 在AIG和AILDs患者中经常观察到其他自身免疫并发症.
研究的目的:
- 为了确定在被诊断为AILD的患者中AIG的流行率.
- 在AILD患者中描述AIG的临床,血清学和组织病理学特征.
- 为AIG-AILD重叠的早期发现和综合管理策略提供信息.
主要方法:
- 对104名确诊患有AILD的患者进行前性研究.
- 在所有参与者中查抗平面细胞抗体 (APCA).
- 在APCA阳性患者中进行内镜和胃活检以进行组织学评估 (更新的悉尼系统).
主要成果:
- 在AILD患者中,APCA阳性被发现在22.1%,主要是女性.
- 组织学AIG在91.3%的APCA阳性患者中得到证实,肠道转化和胃缩的发病率高.
- 自身免疫性甲状腺炎 (43.5%) 和初级胆道胆炎 (PBC,47.8%) 是APCA阳性AIG患者的常见并发症.
结论:
- 在AIG和AILD之间存在着显著的关联,特别是PBC.
- 在AIG-AILD重叠中增加胃缩和潜在瘤变化的风险.
- 考虑针对APCA阳性或甲状腺自身免疫性AILD患者进行针对性AIG查,以改善监测.
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