Osteosarcopenia in autoimmune cholestatic liver diseases: Causes, management, and challenges.
Cholestatic liver diseases
Osteoporosis
Primary biliary cholangitis
Primary sclerosing cholangitis
Sarcopenia
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
14 Apr 2022
14 Apr 2022
Historique:
received:
09
09
2021
revised:
05
12
2021
accepted:
07
03
2022
entrez:
18
5
2022
pubmed:
19
5
2022
medline:
20
5
2022
Statut:
ppublish
Résumé
Primary biliary cholangitis and primary sclerosing cholangitis (PSC) are the most common cholestatic liver diseases (CLD) in adults and are both characterized by an immune pathogenesis. While primary biliary cholangitis is a model autoimmune disease, with over 90% of patients presenting very specific autoantibodies against mitochondrial antigens, PSC is considered an immune mediated disease. Osteoporosis is the most common bone disease in CLD, resulting in frequent fractures and leading to significant morbidity. Further, sarcopenia is emerging as a frequent complication of chronic liver diseases with a significant prognostic impact and severe implications on the quality of life of patients. The mechanisms underlying osteoporosis and sarcopenia in CLD are still largely unknown and the association between these clinical conditions remains to be dissected. Although timely diagnosis, prevention, and management of osteosarcopenia are crucial to limit the consequences, there are no specific guidelines for management of osteoporosis and sarcopenia in patients with CLD. International guidelines recommend screening for bone disease at the time of diagnosis of CLD. However, the optimal monitoring strategies and treatments have not been defined yet and vary among centers. We herein aim to comprehensively outline the pathogenic mechanisms and clinical implications of osteosarcopenia in CLD, and to summarize expert recommendations for appropriate diagnostic and therapeutic approaches.
Identifiants
pubmed: 35582674
doi: 10.3748/wjg.v28.i14.1430
pmc: PMC9048470
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1430-1443Informations de copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: AA has served as a speaker, consultant, and advisory board member for Gilead, MSD, Abbvie, Mylan, Intercept, and Alfasigma and has received research funding from Gilead and Abbvie. AL reports receiving consulting fees from Intercept Pharma, AlfaSigma, AbbVie, Gilead, and MSD and travel expenses from Intercept Pharma, AlfaSigma, and AbbVie. GM received consultant fees from Eli Lilly, Ipsen, and Novartis and lecture fees from Abiogen and Amgen.
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