Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, Denmark Hill Campus, London SE5 9RS, UK.
Ann Hepatol. 2012 Jan-Feb;11(1):7-14.
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.
原发性胆汁性肝硬化（PBC）是一种胆汁淤积性肝病，其特征是小肝内胆管中的胆管上皮细胞发生免疫介导的破坏。该疾病的特征是循环抗线粒体抗体（AMA）以及疾病特异性抗核抗体（ANA）、胆汁淤积性肝功能生化异常和特征性组织学。该疾病主要影响中年女性，其发病率在全球范围内明显增加。流行病学研究表明，PBC 的发生有几个危险因素，其中包括 PBC 的家族史、复发性尿路感染和吸烟。吸烟通过涉及内分泌和免疫系统等多种复杂机制，被认为是包括肝脏在内的几种自身免疫性疾病的危险因素之一。关于吸烟与肝脏疾病关系的研究也表明，吸烟可能会使疾病向纤维化和随后的肝硬化发展。本综述将探讨吸烟作为 PBC 的危险因素的相关文献，以及其作为 PBC 患者纤维化进展的潜在因素。
