Autoimmune diseases in gastroenterology: current state of the problem | Український Медичний Часопис

The article highlights the current state of distribution, risks of development, and methods of treatment of autoimmune diseases in gastroenterology. The aim of the study was to identify and analyze the current state of the problem of autoimmune diseases in gastroenterology. The content analysis of domestic and foreign scientific sources, bibliosemantic and analytical research methods were used. The current state of the problem of autoimmune diseases of the hepatobiliary system and the gastrointestinal tract is analyzed, their prevalence, modern methods of diagnosis and treatment are studied. Today, the search for early diagnosis and effective treatment of autoimmune diseases, such as primary sclerosing cholangitis and biliary cirrhosis, atrophic gastritis, autoimmune pancreatitis, ulcerative colitis and Crohn’s disease, and IgG4-related diseases, continues. The main marker for the detection of autoimmune diseases associated with IgG4 is its detection in blood serum and biopsies. It has been shown that histology alone is the basis for the diagnosis of autoimmune pancreatitis, as there is no specific serological marker for the detection of this disease. For the diagnosis and screening of autoimmune atrophic gastritis, an invasive method, gastroscopy, is used along with non-invasive (serological) diagnostic methods. Diagnosis and treatment of inflammatory bowel disease remains one of the most serious problems in gastroenterology practice. No definitive treatment has been found that can change the course of autoimmune diseases, so the search for biological targets for their treatment is actively ongoing.

References

1. Engel B., Taubert R., Jaeckel E. et al. (2020) The future of autoimmune liver diseases — Understanding pathogenesis and improving morbidity and mortality. Liver Int., 40(1): 149–153. DOI: 10.1111/liv.14378.
2. Chen Y., Wang Q.X., Ma X. (2019) Research advances of autoimmune liver diseases in 2018. Zhonghua Gan Zang Bing Za Zhi., 27(1): 14–17. DOI: 10.3760/cma.j.issn.1007-3418.2019.01.005.
3. Lee C.W., Ronnekleiv-Kelly S. (2019) Autoimmune diseases of the biliary tract. Surg. Clin. North Am., DOI: 10.1016/j.suc.2018.11.003.
4. Trivedi P.J., Hirschfield G.M. (2021) Recent advances in clinical practice: epidemiology of autoimmune liver diseases. Gut, 70(10): 1989–2003. DOI: 10.1136/gutjnl-2020-322362.
5. Mack C.L., Adams D., Assis D.N. et al. (2020) Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American association for the study of liver diseases. Hepatology, 72(2): 671–722. DOI: 10.1002/hep.31065.
6. Sarcognato S., Sacchi D., Grillo F. et al. (2021) Autoimmune biliary diseases: primary biliary cholangitis and primary sclerosing cholangitis. Pathologica, 113(3): 170–184. DOI: 10.32074/1591-951X-245.
7. Floreani A., De Martin S., Secchi M.F. et al. (2019) Extrahepatic autoimmunity in autoimmune liver disease. Eur. J. Int. Med., 59: 1–7. DOI: 10.1016/j.ejim.2018.10.014.
8. Bellan M., Andreoli L., Mele C. et al. (2020) Pathophysiological role and therapeutic implications of vitamin D in autoimmunity: focus on chronic autoimmune diseases. Nutrients, 12(3): 789. doi.org/10.3390/nu12030789.
9. Khandelwal A., Inoue D., Takahashi N. (2020) Autoimmune pancreatitis: an update. Abdomin. Radiol. (New York), 45(5): 1359–1370. DOI: 10.1007/s00261-019-02275-x.
10. Löhr J.M., Vujasinovic M., Rosendahl J. et al. (2022) IgG4-related diseases of the digestive tract. Nature reviews. Gastroenterol. Hepatol., 19(3): 185–197. DOI: 10.1038/s41575-021-00529-y.
11. Lee S.C., Yang C.H., Chang C.T. et al. (2022) Diagnostic utility of serum IgG4 in autoimmune pancreatitis: an updated comprehensive systematic review and meta-analysis. J. Clin. Gastroenterol., 56(9): 810–817. DOI: 10.1097/MCG.0000000000001612.
12. Zingone F., Marsilio I., Fassan M. et al. (2021) Duodenal histological findings and risk of coeliac disease in subjects with autoimmune atrophic gastritis: a retrospective evaluation. Digestion, 102(4): 615–621. DOI: 10.1159/000510354.
13. Lenti M.V., Rugge M., Lahner E. et al. (2020) Autoimmune gastritis. Nat. Rev. Dis. Primers, 6(1): 56. DOI: 10.1038/s41572-020-0187-8.
14. Rodriguez-Castro K.I., Franceschi M., Miraglia C. et al. (2018) Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed., 89(8–S): 100–103. DOI: 10.23750/abm.v89i8-S.7919.
15. Lahner E., Conti L., Annibale B. et al. (2020) Current perspectives in atrophic gastritis. Curr. Gastroenterol. Rep., 22(8): 38. DOI: 10.1007/s11894-020-00775-1.
16. Rustgi S.D., Bijlani P., Shah S.C. (2021) Autoimmune gastritis, with or without pernicious anemia: epidemiology, risk factors, and clinical management. Therap. Adv. Gastroenterol., 14: 17562848211038771. DOI: 10.1177/17562848211038771.
17. Annibale B., Esposito G., Lahner E. (2020) A current clinical overview of atrophic gastritis. Expert. Rev. Gastroenterol. Hepatol., 14(2): 93–102. DOI: 10.1080/17474124.2020.1718491.
18. Rugge M., Genta R.M., Bricca L. et al. (2021) Not all autoimmune gastritis are created the same. Gastroenterol. Res., 14(6): 348–349. DOI: 10.14740/gr1443.
19. Antico A., Tampoia M., Villalta D. et al. (2012) Clinical usefulness of the serological gastric biopsy for the diagnosis of chronic autoimmune gastritis. Clin. Dev. Immunol., 2012: 520970. DOI: 10.1155/2012/520970.
20. Kucharzik T., Koletzko S., Kannengiesser K. et al. (2020) Ulcerative colitis-diagnostic and therapeutic algorithms. Deutsches Arzteblatt Int., 117(33–34): 564–574. DOI: 10.3238/arztebl.2020.0564.
21. Carstens A., Dicksved J., Nelson R. et al. (2019) The gut microbiota in collagenous colitis shares characteristics with inflammatory bowel disease-associated dysbiosis. Clin. Transl. Gastroenterol., 10(7): e00065. DOI: 10.14309/ctg.0000000000000065.
22. Venegas D.P., Marjorie K. De la Fuente, Landskron G. et al. (2019) Short chain fatty acids (SCFAs)-mediated gut epithelial and immune regulation and its relevance for inflammatory bowel. Diseases Front. Immunol., 10: 277. DOI: 10.3389/fimmu.2019.00277.