AIM:Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology,the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA...AIM:Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology,the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (aPBC) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation.However, only 20-30% of patients respond fully to UDCA.Recently,lipoprotein-lowering agents have been found to be effective for PBC.The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory-activated receptor α,in patients with aPBC.METHODS:Fenofibrate was administered for twelve weeks in nine patients with aPBC who failed to respond to UDCA.UDCA was used along with fenofibrate during the study.The data from aPBC patients were analyzed to assess the biochemical effect of fenofibrate during the study.RESULTS: The serum levels of alkaline phosphatase (ALP)(285±114.8IU/L) and immunoglobulin M (IgM) (255.8±85.9mg/dl) significantly decreased to 186.9±76.2IU/L and 192.9±67.5mg/dL respectively, after fenofibrate treatment in patients with aPBC (P<0.05). Moreover,the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in any patients.CONCLUSION:Fenofibrate appears to be significantly effective in treating patients with aPBC who respond incompletely to UDCA alone.Although the mechanism of fenofibrate on aPBC has not yet been fully clarified,combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its antiinflammatory effect.展开更多
Helicobacter pylori(H pylori) infection is a leading world-wide infectious disease as it affects more than half of the world population and causes chronic gastritis,peptic ulcer disease and gastric malignancies.The in...Helicobacter pylori(H pylori) infection is a leading world-wide infectious disease as it affects more than half of the world population and causes chronic gastritis,peptic ulcer disease and gastric malignancies.The infection elicits a chronic cellular inflammatory response in the gastric mucosa.However,the effects of this local inflammation may not be confi ned solely to the digestive tract but may spread to involve extraintestinal tissues and/or organs.Indeed,H pylori infection has been epidemiologically linked to extra-digestive conditions and diseases.In this context,it has been speculated that H pylori infection may be responsible for various endocrine disorders,such as autoimmune thyroid diseases,diabetes mellitus,dyslipidemia,obesity,osteoporosis and primary hyperparathyroidism.This is a review of the relationship between H pylori infection and these endocrine disorders.展开更多
文摘AIM:Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology,the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (aPBC) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation.However, only 20-30% of patients respond fully to UDCA.Recently,lipoprotein-lowering agents have been found to be effective for PBC.The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory-activated receptor α,in patients with aPBC.METHODS:Fenofibrate was administered for twelve weeks in nine patients with aPBC who failed to respond to UDCA.UDCA was used along with fenofibrate during the study.The data from aPBC patients were analyzed to assess the biochemical effect of fenofibrate during the study.RESULTS: The serum levels of alkaline phosphatase (ALP)(285±114.8IU/L) and immunoglobulin M (IgM) (255.8±85.9mg/dl) significantly decreased to 186.9±76.2IU/L and 192.9±67.5mg/dL respectively, after fenofibrate treatment in patients with aPBC (P<0.05). Moreover,the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in any patients.CONCLUSION:Fenofibrate appears to be significantly effective in treating patients with aPBC who respond incompletely to UDCA alone.Although the mechanism of fenofibrate on aPBC has not yet been fully clarified,combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its antiinflammatory effect.
文摘Helicobacter pylori(H pylori) infection is a leading world-wide infectious disease as it affects more than half of the world population and causes chronic gastritis,peptic ulcer disease and gastric malignancies.The infection elicits a chronic cellular inflammatory response in the gastric mucosa.However,the effects of this local inflammation may not be confi ned solely to the digestive tract but may spread to involve extraintestinal tissues and/or organs.Indeed,H pylori infection has been epidemiologically linked to extra-digestive conditions and diseases.In this context,it has been speculated that H pylori infection may be responsible for various endocrine disorders,such as autoimmune thyroid diseases,diabetes mellitus,dyslipidemia,obesity,osteoporosis and primary hyperparathyroidism.This is a review of the relationship between H pylori infection and these endocrine disorders.
