Tanaka Atsushi, Ma Xiong, Yokosuka Osamu, Weltman Martin, You Hong, Amarapurkar Deepak N, Kim Yoon Jun, Abbas Zaigham, Payawal Diana A, Chang Ming-Ling, Efe Cumali, Ozaslan Ersan, Abe Masanori, Mitchell-Thain Robert, Zeniya Mikio, Han Kwang Hyub, Vierling John M, Takikawa Hajime
Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Hepatol Int. 2016 Nov;10(6):909-915. doi: 10.1007/s12072-016-9767-9. Epub 2016 Sep 20.
During the 25th annual meeting of the Asia-Pacific Association for the Study of the Liver (APASL 2016) in Tokyo, we organized and moderated an inaugural satellite symposium on the autoimmune liver diseases, autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Following the keynote lecture by John M. Vierling (USA), speakers from the Asia-Pacific region provided an up-to-date perspective on the epidemiology, clinical practice and research in AIH and PBC in the Asia-Pacific region. Although epidemiology and clinical features of AIH seem to be similar in East Asia compared to those in western countries, the majority of patients with AIH are detected at an advanced stage and have higher mortality rates in South Asia, indicating an unmet need for earlier diagnosis and the initiation of appropriate immunosuppressive treatment. PBC is more commonly seen in Australia and East Asia. As of 2016, clinical practice guidelines (CPG) for PBC have been published in Japan and China. Ursodeoxycholic acid (UDCA) is recommended as a first-line therapy by both CPG. Nevertheless, one of the unmet therapeutic needs in PBC is the treatment of patients refractory to or intolerant of UDCA. It is of interest that the prevalence of chronic hepatitis B (CHB) in PBC patients was low in Taiwan and mainland China where the prevalence of CHB is very high. In this review, we overview this exciting and epoch-making symposium.
在东京举行的第25届亚太肝脏研究协会年会(APASL 2016)期间,我们组织并主持了一场关于自身免疫性肝病、自身免疫性肝炎(AIH)和原发性胆汁性胆管炎(PBC)的首届卫星研讨会。在约翰·M·维林(美国)发表主题演讲之后,来自亚太地区的演讲者就亚太地区AIH和PBC的流行病学、临床实践及研究提供了最新观点。尽管与西方国家相比,东亚地区AIH的流行病学和临床特征似乎相似,但在南亚,大多数AIH患者在晚期才被确诊,且死亡率较高,这表明对早期诊断及启动适当免疫抑制治疗存在未满足的需求。PBC在澳大利亚和东亚更为常见。截至2016年,日本和中国已发布了PBC临床实践指南(CPG)。两种CPG均推荐熊去氧胆酸(UDCA)作为一线治疗药物。然而,PBC未满足的治疗需求之一是对UDCA难治或不耐受患者的治疗。有趣的是,在慢性乙型肝炎(CHB)患病率很高的台湾和中国大陆,PBC患者中CHB的患病率却很低。在这篇综述中,我们概述了这场激动人心且具有划时代意义的研讨会。