Environmental risk factors are associated with autoimmune hepatitis.
Environmental risk factors are associated with autoimmune hepatitis.
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DOI：
10.1111/liv.14944
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Lazaridis KN
中科院分区：
文献类型：
--
作者：
Lammert C;Chalasani SN;Atkinson EJ;McCauley BM;Lazaridis KN
自身免疫性肝炎（AIH）中免疫稳态的失败和由此导致的肝细胞破坏可能是环境触发因素在容许的遗传结构中的结果。我们的目的是在一个表型良好的AIH队列中确定与AIH相关的危险因素。我们前瞻性地收集了358例AIH患者和563名健康对照者的环境问卷。应答频率采用逻辑回归进行比较，并根据招募时的年龄、性别和教育程度进行调整。与对照组相比，AIH患者更可能发生尿路感染（UTI）（53.6% vs 33.9%，P <0.001）和复发性UTI（每年超过1次）（23.5% vs 15.9%，P = 0.002）。与对照组相比，女性病例更频繁地使用口服避孕药（83.0% vs 73.7%，P = 0.006），更少的妊娠（中位数= 1 vs 3，P <0.001）和更少使用激素替代疗法（28.5% vs 60.1%，P <0.001）。目前吸烟在病例中更普遍（18.9% vs 7.4%，P = 0.022），但根据历史吸烟行为未观察到差异。最后，病例不太可能有腮腺炎病史（32.4% vs 53.1%，P = .011）和风湿热（1.1% vs 4.4%，P = .028），但报告水痘疫苗接种频率较高麻疹、腮腺炎、风疹、百日咳、肺炎球菌感染率分别为38%和28.1%、66.5%和39.3%、58.7%和34.6%、55.3%和32.7%、59.8%和40.1%（P < .002）。环境因素在AIH发病中起重要作用。这些发现的重复和前瞻性检查可能为AIH的发病和结局提供新的见解。
Failure of immunologic homeostasis and resultant hepatocyte destruction in autoimmune hepatitis (AIH) is likely the result of environmental triggers within a permissive genetic architecture. We aimed to identify risk factors associated with AIH in a well‐phenotyped AIH cohort. We prospectively collected environmental questionnaires from 358 AIH cases and 563 healthy controls. Response frequencies were compared using logistic regression, adjusting for age at recruitment, sex and education. AIH cases were more likely to ever have a urinary tract infection (UTI) (53.6% vs 33.9%, P < .001) and recurrent UTI (more than 1 per year) (23.5% vs 15.9%, P = .002) compared to controls. Female cases more frequently had ever used oral contraceptives (83.0% vs 73.7%, P = .006), fewer pregnancies (median = 1 vs 3, P < .001) and less often used hormone replacement therapy compared to controls (28.5% vs 60.1%, P < .001). Current smoking was more prevalent in cases (18.9% vs 7.4%, P = .022), yet no difference according to historical smoking behaviours was observed. Finally, cases were less likely to have history of mumps (32.4% vs 53.1%, P = .011) and rheumatic fever (1.1% vs 4.4%, P = .028), but reported higher vaccination frequency to chicken pox (38% vs 28.1%), measles (66.5% vs 39.3%), mumps (58.7% vs 34.6%), rubella (55.3% vs 32.7%), pertussis (59.8% vs 40.1%) and pneumococcus (47.2% VS 39.4%) (P < .002). Environmental factors are important in AIH pathogenesis. Replication of these findings and prospective examination may provide new insight into AIH onset and outcomes.
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影响因子：
25.7
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
25.7
作者：
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通讯作者：
Poupon, Raoul
DOI：
10.1016/j.cgh.2016.05.043
发表时间：
2017-01
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
de Boer YS;Kosinski AS;Urban TJ;Zhao Z;Long N;Chalasani N;Kleiner DE;Hoofnagle JH;Drug-Induced Liver Injury Network
通讯作者：
Drug-Induced Liver Injury Network