Cargando…
Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis
AIM: The aim of this systematic review was to determine if the human colon, through the lower gut-liver axis, drives PSC activity by assessing the progression of the disease in patients with and without colectomy for colonic disease. BACKGROUND: The gut-liver axis is involved in the pathogenesis of...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Shaheed Beheshti University of Medical Sciences
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204254/ https://www.ncbi.nlm.nih.gov/pubmed/30425805 |
_version_ | 1783366014486970368 |
---|---|
author | Ong, John Bath, Michael F. Swift, Carla Al-Naeeb, Yasseen |
author_facet | Ong, John Bath, Michael F. Swift, Carla Al-Naeeb, Yasseen |
author_sort | Ong, John |
collection | PubMed |
description | AIM: The aim of this systematic review was to determine if the human colon, through the lower gut-liver axis, drives PSC activity by assessing the progression of the disease in patients with and without colectomy for colonic disease. BACKGROUND: The gut-liver axis is involved in the pathogenesis of liver disease. Abnormal immune-mediated responses to intestinal microbiome are implicated in primary sclerosing cholangitis (PSC) however the mechanisms remain poorly understood. Currently, no single animal model recapitulates all attributes of PSC in humans and this limits further studies of gut-liver interactions. METHODS: A systematic search of PubMed, Medline, and Scopus was performed for articles that contained the terms “colectomy” or “bowel resection” AND “primary sclerosing cholangitis” up to 15th April 2018. Articles were reviewed by 2 reviewers and raw data collated. A Forest plot was used to illustrate the effect of colectomy on subsequent liver transplantation for PSC. Linear regression was used to estimate mortality risk. RESULTS: Colectomy appeared to have no effect on PSC progression, although high-quality studies were lacking. Rates of liver transplantation or transjugular intrahepatic portosystemic shunt for PSC were not affected by colectomy (OR 0.59, 95% CI 0.14 - 2.53, p=0.48). Mortality risk following colectomy in patients with PSC is 2.11% per year (95% CI 0.03% - 4.18%, p=0.032, R2 = 0.722). CONCLUSION: Current evidence is limited but suggests colectomy does not affect the progression of PSC in patients with colonic disease. Pathogenic micro-organisms or antigens that drive PSC may not be limited to the lower gut. |
format | Online Article Text |
id | pubmed-6204254 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Shaheed Beheshti University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-62042542018-11-13 Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis Ong, John Bath, Michael F. Swift, Carla Al-Naeeb, Yasseen Gastroenterol Hepatol Bed Bench Systematic Review AIM: The aim of this systematic review was to determine if the human colon, through the lower gut-liver axis, drives PSC activity by assessing the progression of the disease in patients with and without colectomy for colonic disease. BACKGROUND: The gut-liver axis is involved in the pathogenesis of liver disease. Abnormal immune-mediated responses to intestinal microbiome are implicated in primary sclerosing cholangitis (PSC) however the mechanisms remain poorly understood. Currently, no single animal model recapitulates all attributes of PSC in humans and this limits further studies of gut-liver interactions. METHODS: A systematic search of PubMed, Medline, and Scopus was performed for articles that contained the terms “colectomy” or “bowel resection” AND “primary sclerosing cholangitis” up to 15th April 2018. Articles were reviewed by 2 reviewers and raw data collated. A Forest plot was used to illustrate the effect of colectomy on subsequent liver transplantation for PSC. Linear regression was used to estimate mortality risk. RESULTS: Colectomy appeared to have no effect on PSC progression, although high-quality studies were lacking. Rates of liver transplantation or transjugular intrahepatic portosystemic shunt for PSC were not affected by colectomy (OR 0.59, 95% CI 0.14 - 2.53, p=0.48). Mortality risk following colectomy in patients with PSC is 2.11% per year (95% CI 0.03% - 4.18%, p=0.032, R2 = 0.722). CONCLUSION: Current evidence is limited but suggests colectomy does not affect the progression of PSC in patients with colonic disease. Pathogenic micro-organisms or antigens that drive PSC may not be limited to the lower gut. Shaheed Beheshti University of Medical Sciences 2018 /pmc/articles/PMC6204254/ /pubmed/30425805 Text en ©2018 RIGLD, Research Institute for Gastroenterology and Liver Diseases This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Systematic Review Ong, John Bath, Michael F. Swift, Carla Al-Naeeb, Yasseen Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis |
title | Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis |
title_full | Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis |
title_fullStr | Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis |
title_full_unstemmed | Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis |
title_short | Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis |
title_sort | does colectomy affect the progression of primary sclerosing cholangitis? a systematic review and meta-analysis |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204254/ https://www.ncbi.nlm.nih.gov/pubmed/30425805 |
work_keys_str_mv | AT ongjohn doescolectomyaffecttheprogressionofprimarysclerosingcholangitisasystematicreviewandmetaanalysis AT bathmichaelf doescolectomyaffecttheprogressionofprimarysclerosingcholangitisasystematicreviewandmetaanalysis AT swiftcarla doescolectomyaffecttheprogressionofprimarysclerosingcholangitisasystematicreviewandmetaanalysis AT alnaeebyasseen doescolectomyaffecttheprogressionofprimarysclerosingcholangitisasystematicreviewandmetaanalysis |