{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T19:14:15Z","timestamp":1764270855536,"version":"3.46.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Epidemiol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The pathogenesis of primary sclerosing cholangitis (PSC), a severe autoimmune liver disease, remains largely unknown. Infection with\n                    <jats:italic>Helicobacter pylori<\/jats:italic>\n                    (\n                    <jats:italic>H. pylori<\/jats:italic>\n                    ) and subsequent gastritis could act as a triggering event of PSC, as\n                    <jats:italic>H. pylori<\/jats:italic>\n                    seems to be more prevalent in chronic liver disease. However, the risk of PSC among patients with gastritis and its precursor,\n                    <jats:italic>H. pylori<\/jats:italic>\n                    infection, is undetermined. In this nationwide cohort study, we included Swedish individuals undergoing a gastroscopy with biopsy during 1990\u20132017 showing gastritis (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009306 588) or\n                    <jats:italic>H. pylori<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911 890). Three control groups were used (1) matched controls from the Swedish general population (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091 544 667), (2) individuals with a gastric biopsy indicating normal mucosa (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009318 754) and (3) sibling controls (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009231 879). We calculated the hazard ratios (HRs) for PSC development, adjusting for age, sex, calendar year, county, comorbidities, alcohol-related disorders, education, and country of birth. Patients with a histological diagnosis of gastritis or\n                    <jats:italic>H. pylori<\/jats:italic>\n                    were more likely to be diagnosed with PSC during follow up. Compared to the general Swedish population, the fully adjusted HR for PSC among patients with gastritis was 3.35 (95% CI 2.67\u20134.20). However, compared to secondary controls with a normal gastric mucosa, the PSC risk was not increased among patients with gastritis. Patients with a gastroscopy biopsy showing gastritis have a moderately increased risk for PSC later in life but not compared to other individuals undergoing gastrointestinal work up (\u201cnormal mucosa)\u201d. The association with PSC may be non-specific and apply to several gastrointestinal disorders.\n                  <\/jats:p>","DOI":"10.1007\/s10654-025-01293-y","type":"journal-article","created":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T02:15:26Z","timestamp":1755915326000},"page":"1243-1250","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of primary sclerosing cholangitis among patients with gastritis: a nationwide cohort study"],"prefix":"10.1007","volume":"40","author":[{"given":"Lina Lindstr\u00f6m","family":"\u00c4lg\u00e5","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0445-6630","authenticated-orcid":false,"given":"Isabella","family":"Ekheden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Thuresson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas F.","family":"Ludvigsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"issue":"2","key":"1293_CR1","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1002\/hep.23678","volume":"52","author":"B Lindkvist","year":"2010","unstructured":"Lindkvist B, et al. Incidence and prevalence of primary sclerosing cholangitis in a defined adult population in Sweden. Hepatology. 2010;52(2):571\u20137.","journal-title":"Hepatology"},{"key":"1293_CR2","unstructured":"Melum. NLTR annual report 2023. Melum; 2023."},{"issue":"6","key":"1293_CR3","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1016\/j.jhep.2017.07.022","volume":"67","author":"TH Karlsen","year":"2017","unstructured":"Karlsen TH, et al. Primary sclerosing cholangitis - a comprehensive review. J Hepatol. 2017;67(6):1298\u2013323.","journal-title":"J Hepatol"},{"issue":"3","key":"1293_CR4","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1038\/s41564-018-0333-1","volume":"4","author":"N Nakamoto","year":"2019","unstructured":"Nakamoto N, et al. Gut pathobionts underlie intestinal barrier dysfunction and liver T helper 17 cell immune response in primary sclerosing cholangitis. Nat Microbiol. 2019;4(3):492\u2013503.","journal-title":"Nat Microbiol"},{"issue":"6","key":"1293_CR5","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1038\/s41591-023-02372-x","volume":"29","author":"DG Shaw","year":"2023","unstructured":"Shaw DG, et al. Antigen-driven colonic inflammation is associated with development of dysplasia in primary sclerosing cholangitis. Nat Med. 2023;29(6):1520\u20139.","journal-title":"Nat Med"},{"issue":"10","key":"1293_CR6","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1097\/MEG.0000000000001223","volume":"30","author":"GP de Chambrun","year":"2018","unstructured":"de Chambrun GP, et al. Oral Vancomycin induces sustained deep remission in adult patients with ulcerative colitis and primary sclerosing cholangitis. Eur J Gastroenterol Hepatol. 2018;30(10):1247\u201352.","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"8","key":"1293_CR7","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/j.cgh.2008.03.016","volume":"6","author":"A Bergquist","year":"2008","unstructured":"Bergquist A, et al. Increased risk of primary sclerosing cholangitis and ulcerative colitis in first-degree relatives of patients with primary sclerosing cholangitis. Clin Gastroenterol Hepatol. 2008;6(8):939\u201343.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"1293_CR8","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1128\/JCM.38.3.1072-1076.2000","volume":"38","author":"HO Nilsson","year":"2000","unstructured":"Nilsson HO, et al. Identification of Helicobacter pylori and other Helicobacter species by PCR, hybridization, and partial DNA sequencing in human liver samples from patients with primary sclerosing cholangitis or primary biliary cirrhosis. J Clin Microbiol. 2000;38(3):1072\u20136.","journal-title":"J Clin Microbiol"},{"issue":"30","key":"1293_CR9","doi-asserted-by":"publisher","first-page":"2968","DOI":"10.4254\/wjh.v7.i30.2968","volume":"7","author":"EM Rabelo-Gon\u00e7alves","year":"2015","unstructured":"Rabelo-Gon\u00e7alves EM, Roesler BM, Zeitune JM. Extragastric manifestations of Helicobacter pylori infection: possible role of bacterium in liver and pancreas diseases. World J Hepatol. 2015;7(30):2968\u201379.","journal-title":"World J Hepatol"},{"issue":"6","key":"1293_CR10","doi-asserted-by":"publisher","first-page":"657","DOI":"10.3109\/00365521.2015.1019918","volume":"50","author":"P Sipponen","year":"2015","unstructured":"Sipponen P, Maaroos HI. Chronic gastritis. 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Colectomy prior to diagnosis of primary sclerosing cholangitis is associated with improved prognosis in a nationwide cohort study of 2594 PSC-IBD patients. Aliment Pharmacol Ther. 2018;47(2):238\u201345.","journal-title":"Aliment Pharmacol Ther"},{"issue":"9","key":"1293_CR16","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1016\/j.cgh.2018.11.002","volume":"17","author":"K Stokkeland","year":"2019","unstructured":"Stokkeland K, et al. Statin use is associated with improved outcomes of patients with primary sclerosing cholangitis. Clin Gastroenterol Hepatol. 2019;17(9):1860\u2013e18661.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"6","key":"1293_CR17","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1111\/apt.16735","volume":"55","author":"A Forss","year":"2022","unstructured":"Forss A, et al. A nationwide cohort study of the incidence of inflammatory bowel disease in Sweden from 1990 to 2014. 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World J Hepatol. 2015;7(18):2136\u201346.","journal-title":"World J Hepatol"}],"container-title":["European Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-025-01293-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10654-025-01293-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-025-01293-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T19:02:21Z","timestamp":1764270141000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10654-025-01293-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,23]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["1293"],"URL":"https:\/\/doi.org\/10.1007\/s10654-025-01293-y","relation":{},"ISSN":["0393-2990","1573-7284"],"issn-type":[{"type":"print","value":"0393-2990"},{"type":"electronic","value":"1573-7284"}],"subject":[],"published":{"date-parts":[[2025,8,23]]},"assertion":[{"value":"21 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JFL has coordinated a study on behalf of the Swedish IBD quality register (SWIBREG). That study received funding from Janssen Corporation. JFL has also received financial support from MSD developing a paper reviewing national healthcare registers in China. JFL has a research collaboration on celiac disease with Takeda, and with MSD on IBD. The other authors report no disclosures relevant to the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was approved by the Stockholm Ethics Review Board (2014\/1287-31\/4, 2018\/972\u2009\u2212\u200932, and 2022-05774-02).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Individual informed consent was waived as the study was register-based.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}