Primary Biliary Cirrhosis Clinical Trial
Official title:
Identification of Inflammatory and Fibrotic Biomarkers in PBC and NAFLD Patients
Primary biliary cirrhosis (PBC) is a progressive autoimmune disease of biliary epithelial
cells resulting in biliary cirrhosis. PBC is characterized by a 90% female predominance, high
titers of serum anti-mitochondrial autoantibodies (AMA) directed against the pyruvate
dehydrogenase complex E2 subunit and evidence from both human and murine models suggests that
T-cells, particularly cluster of differentiation (CD) 8+ T cells, are key to the destruction
of bile ducts. However, clinical trials of classic immunosuppressive drugs including
corticosteroids, azathioprine, methotrexate, and tacrolimus have been largely unsuccessful in
altering the disease course. This is a single center, prospective, non-treatment study of the
role of immune responses in PBC patients.
Non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic
steatohepatitis (NASH) are common, often "silent" liver diseases. NASH resembles alcoholic
liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH
is fat in the liver, along with inflammation and fibrosis. NASH can be severe and can lead to
cirrhosis and hepatocellular carcinoma. Ten to 20 percent of American have NAFLD with NASH
affecting 2 to 5 percent of Americans.
In this study, the investigators will prospectively collect demographic, clinical, and laboratory data and blood samples for research purposes on 45 PBC patients and 50 male and female NAFLD patients. PBC and NAFLD diagnosis and clinical status will be evaluated by magnetic resonance (MR) elastography, transient elastography (FibroScan®) and blood lab analysis including anti-mitochondrial antibodies (AMA), anti-nuclear antibodies (ANA), immunoglobulins, complete blood count (CBC), comprehensive metabolic panel (CMP) and coagulation measures). Additionally serum and blood will be obtained from the patients on the first visit and at months 3, 6, 9, 12, 15, 18, 21 & 24. Serum and blood samples will be used to measure serum cytokine abundance and transcriptome analysis. For comparison, 95 age (+/- 5 years) and sex-matched controls without PBC will be recruited for a clinical laboratory, cytokine, gene expression analysis. Control subjects will have blood drawn at a single time point. ;
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