{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T13:17:36Z","timestamp":1794057456813,"version":"4.8.0"},"reference-count":140,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/crealrvecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Am J Gastroenterol"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>Primary biliary cholangitis (PBC) is a chronic, cholestatic, autoimmune disease with a variable progressive course. PBC can cause debilitating symptoms including fatigue and pruritus and, if left untreated, is associated with a high risk of cirrhosis and related complications, liver failure, and death. Recent changes to the PBC landscape include a name change, updated guidelines for diagnosis and treatment as well as new treatment options that have recently become available. Practicing clinicians face many unanswered questions when managing PBC. To assist these healthcare providers in managing patients with PBC, the American College of Gastroenterology (ACG) Institute for Clinical Research &amp; Education, in collaboration with the Chronic Liver Disease Foundation (CLDF), organized a panel of experts to evaluate and summarize the most current and relevant peer-reviewed literature regarding PBC. This, combined with the extensive experience and clinical expertise of this expert panel, led to the formation of this clinical guidance on the diagnosis and management of PBC.<\/jats:p>","DOI":"10.1038\/s41395-018-0390-3","type":"journal-article","created":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T07:14:46Z","timestamp":1542179686000},"page":"48-63","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":198,"title":["Diagnosis and Management of Primary Biliary Cholangitis"],"prefix":"10.14309","volume":"114","author":[{"given":"Zobair M.","family":"Younossi","sequence":"first","affiliation":[{"name":"Department of Medicine, Inova Fairfax Hospital, 3300 Gallows Rd, Falls Church, VA, 22042, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Sandra Atlas Bass Center for Liver Diseases, Zucker School of Medicine at Hofstra\/Northwell, Hempstead, NY, 11549, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell L.","family":"Shiffman","sequence":"additional","affiliation":[{"name":"Bon Secours Liver Institute of Virginia, Bon Secours Medical Group, Richmond, VA, 23226, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kwo","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, Palo Alto, CA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Ray","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris V.","family":"Kowdley","sequence":"additional","affiliation":[{"name":"Liver Care Network and Organ Care Research, Swedish Medical Center, Seattle, WA, 98107, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira M.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"NYU Langone Health, New York, NY, 10016, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250611","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/j.jhep.2015.06.031","article-title":"Changing nomenclature for PBC: from \u2018cirrhosis\u2019 to \u2018cholangitis\u2019. American Association for the Study of Liver Diseases","volume":"63","author":"Beuers","year":"2015","journal-title":"J Hepatol"},{"key":"R2-20250611","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1053\/jlts.2003.50213","article-title":"Recurrence of primary biliary cirrhosis after liver transplantation: histologic estimate of incidence and natural history","volume":"9","author":"Sylvestre","year":"2003","journal-title":"Liver Transpl"},{"key":"R4-20250611","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jhep.2017.03.022","article-title":"EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis","volume":"67","year":"2017","journal-title":"J Hepatol"},{"key":"R5-20250611","article-title":"Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases","author":"Lindor","year":"2018","journal-title":"Hepatology"},{"key":"R6-20250611","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1053\/gast.2000.20197","article-title":"Epidemiology and natural history of primary biliary cirrhosis in a US community","volume":"119","author":"Kim","year":"2000","journal-title":"Gastroenterology"},{"key":"R7-20250611","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.cgh.2017.12.033","article-title":"Increasing prevalence of primary biliary cholangitis and reduced mortality with treatment","volume":"16","author":"Lu","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R8-20250611","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1002\/hep.21759","article-title":"Differences between Caucasian, African American, and Hispanic patients with primary biliary cirrhosis in the United States","volume":"46","author":"Peters","year":"2007","journal-title":"Hepatology"},{"key":"R9-20250611","first-page":"8","article-title":"2010 Government disease registry, Hirohara","volume":"110","author":"Hirohara","year":"2013","journal-title":"Nihon Shokakibyo Gakkai Zasshi"},{"key":"R10-20250611","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/1471-230X-10-100","article-title":"Prevalence of primary biliary cirrhosis in adults referring hospital for annual health check-up in Southern China","volume":"10","author":"Liu","year":"2010","journal-title":"BMC Gastroenterol"},{"key":"R11-20250611","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1159\/000444471","article-title":"The pathogenesis of autoimmune liver disease","volume":"34","author":"Arndtz","year":"2016","journal-title":"Dig Dis"},{"key":"R12-20250611","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1136\/gut.25.2.133","article-title":"Bacteriuria and primary biliary cirrhosis","volume":"25","author":"Burroughs","year":"1984","journal-title":"Gut"},{"key":"R13-20250611","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jaut.2005.01.012","article-title":"Phylogenetic and immunological definition of four lipoylated proteins from Novosphingobium aromaticivorans, implications for primary biliary cirrhosis","volume":"24","author":"Padgett","year":"2005","journal-title":"J Autoimmun"},{"key":"R14-20250611","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1053\/jhep.2003.50446","article-title":"Patients with primary biliary cirrhosis react against a ubiquitous xenobiotic-metabolizing bacterium","volume":"38","author":"Selmi","year":"2003","journal-title":"Hepatology"},{"key":"R15-20250611","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1053\/j.gastro.2004.05.005","article-title":"Primary biliary cirrhosis in monozygotic and dizygotic twins: genetics, epigenetics, and environment","volume":"127","author":"Selmi","year":"2004","journal-title":"Gastroenterology"},{"key":"R16-20250611","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1053\/j.gastro.2004.05.033","article-title":"Lack of immunological or molecular evidence for a role of mouse mammary tumor retrovirus in primary biliary cirrhosis","volume":"127","author":"Selmi","year":"2004","journal-title":"Gastroenterology"},{"key":"R17-20250611","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.1056\/NEJMoa0810440","article-title":"Primary biliary cirrhosis associated with HLA, IL12A, and IL12RB2 variants","volume":"360","author":"Hirschfield","year":"2009","journal-title":"N Engl J Med"},{"key":"R18-20250611","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1038\/ng.627","article-title":"Genome-wide meta-analyses identify three loci associated with primary biliary cirrhosis","volume":"42","author":"Liu","year":"2010","journal-title":"Nat Genet"},{"key":"R19-20250611","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1002\/hep.21076","article-title":"Increased prevalence of primary biliary cirrhosis near superfund toxic waste sites","volume":"43","author":"Ala","year":"2006","journal-title":"Hepatology"},{"key":"R20-20250611","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1111\/j.1478-3231.2008.01942.x","article-title":"Mycoplasma antigens as a possible trigger for the induction of antimitochondrial antibodies in primary biliary cirrhosis","volume":"29","author":"Berg","year":"2009","journal-title":"Liver Int"},{"key":"R21-20250611","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s12016-008-8087-9","article-title":"Bacteria and primary biliary cirrhosis","volume":"36","author":"Bogdanos","year":"2009","journal-title":"Clin Rev Allergy Immunol"},{"key":"R22-20250611","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1053\/j.gastro.2003.09.034","article-title":"Autoreactivity to lipoate and a conjugated form of lipoate in primary biliary cirrhosis","volume":"125","author":"Bruggraber","year":"2003","journal-title":"Gastroenterology"},{"key":"R23-20250611","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/hep.23139","article-title":"Are transient environmental agents involved in the cause of primary biliary cirrhosis? Evidence from spacetime clustering analysis","volume":"50","author":"McNally","year":"2009","journal-title":"Hepatology"},{"key":"R24-20250611","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jaut.2006.06.002","article-title":"Identification of 2-nonynoic acid, a cosmetic component, as a potential trigger of primary biliary cirrhosis","volume":"27","author":"Rieger","year":"2006","journal-title":"J Autoimmun"},{"key":"R25-20250611","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jaut.2007.02.003","article-title":"The X and why of xenobiotics in primary biliary cirrhosis","volume":"28","author":"Rieger","year":"2007","journal-title":"J Autoimmun"},{"key":"R26-20250611","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1002\/hep.22540","article-title":"Xenobiotic incorporation into pyruvate dehydrogenase complex can occur via the exogenous lipoylation pathway","volume":"48","author":"Walden","year":"2008","journal-title":"Hepatology"},{"key":"R27-20250611","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1002\/hep.22390","article-title":"Loss of tolerance in C57BL\/6 mice to the autoantigen E2 subunit of pyruvate dehydrogenase by a xenobiotic with ensuing biliary ductular disease","volume":"48","author":"Wakabayashi","year":"2008","journal-title":"Hepatology"},{"key":"R28-20250611","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1365-2249.2008.03837.x","article-title":"Induction of autoimmune cholangitis in non-obese diabetic (NOD).1101 mice following a chemical xenobiotic immunization","volume":"155","author":"Wakabayashi","year":"2009","journal-title":"Clin Exp Immunol"},{"key":"R29-20250611","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/00042737-199906000-00004","article-title":"Genetic susceptibility to primary biliary cirrhosis","volume":"11","author":"Agarwal","year":"1999","journal-title":"Eur J Gastro Hep"},{"key":"R30-20250611","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1136\/ard.60.6.639a","article-title":"HLA-DRB1 and DQB1 genes in anticentromere antibody positive patients with SSc and primary biliary cirrhosis","volume":"60","author":"Akimoto","year":"2001","journal-title":"Ann Rhuem Dis"},{"key":"R31-20250611","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1196\/annals.1381.028","article-title":"The clinical significance of IgA antimitochondrial antibodies in sera and saliva in primary biliary cirrhosis","volume":"1107","author":"Tanaka","year":"2007","journal-title":"Ann N Y Acad Sci"},{"key":"R32-20250611","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1002\/hep.21583","article-title":"A sensitive bead assay for antimitochondrial antibodies: chipping away at AMA-negative primary biliary cirrhosis","volume":"45","author":"Oertelt","year":"2007","journal-title":"Hepatology"},{"key":"R33-20250611","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1002\/hep.21123","article-title":"Liver-targeted and peripheral blood alterations of regulatory T cells in primary biliary cirrhosis","volume":"43","author":"Lan","year":"2006","journal-title":"Hepatology"},{"key":"R34-20250611","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jhep.2010.02.019","article-title":"Demographic, lifestyle, medical and familial factors associated with primary biliary cirrhosis","volume":"53","author":"Corpechot","year":"2010","journal-title":"J Hepatol"},{"key":"R35-20250611","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/1471-230X-12-110","article-title":"Primary biliary cirrhosis in a genetically homogeneous population: disease associations and familial occurrence rates","volume":"12","author":"Mantaka","year":"2012","journal-title":"BMC Gastroenterol"},{"key":"R36-20250611","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1053\/jhep.2001.21165","article-title":"Risk factors for primary biliary cirrhosis in a cohort of patients from the United States","volume":"33","author":"Parikh-Patel","year":"2001","journal-title":"Hepatology"},{"key":"R37-20250611","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1136\/gut.2009.184218","article-title":"Case-control studies of risk factors for primary biliary cirrhosis in two United Kingdom populations","volume":"59","author":"Prince","year":"2010","journal-title":"Gut"},{"key":"R38-20250611","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1002\/hep.20907","article-title":"Risk factors and comorbidities in primary biliary cirrhosis: a controlled interview based study of 1032 patients","volume":"42","author":"Gershwin","year":"2005","journal-title":"Hepatology"},{"key":"R39-20250611","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1053\/he.2000.7050","article-title":"An exploratory populationbased case-control study of primary biliary cirrhosis","volume":"31","author":"Howel","year":"2000","journal-title":"Hepatology"},{"key":"R40-20250611","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1016\/S0016-5085(03)00387-1","article-title":"Molecular mimicry of mitochondrial and nuclear autoantigens in primary biliary cirrhosis","volume":"124","author":"Shimoda","year":"2003","journal-title":"Gastroenterology"},{"key":"R41-20250611","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1034\/j.1600-0528.2002.00021h.x","article-title":"Autoreactive responses to pyruvate dehydrogenase complex in the pathogenesis of primary biliary cirrhosis","volume":"174","author":"Yeaman","year":"2000","journal-title":"Immunol Rev"},{"key":"R42-20250611","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/hep.1840170208","article-title":"Eosinophilic infiltration of the liver in primary biliary cirrhosis: a morphological study","volume":"17","author":"Terasaki","year":"1993","journal-title":"Hepatology"},{"key":"R43-20250611","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jaut.2008.04.009","article-title":"The consequences of apoptosis in autoimmunity","volume":"31","author":"Lleo","year":"2008","journal-title":"J Autoimmun"},{"key":"R44-20250611","first-page":"1383","article-title":"Characterization of recombinant monoclonal IgA anti-PDC-E2 autoantibodies derived from patients with PBC","volume":"36","author":"Fukushima","year":"2002","journal-title":"Hepatology"},{"key":"R45-20250611","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1172\/JCI200110716","article-title":"Bcl-2-dependent oxidation of pyruvate dehydrogenase-E2, a primary biliary cirrhosis autoantigen, during apoptosis","volume":"108","author":"Odin","year":"2001","journal-title":"J Clin Invest"},{"key":"R46-20250611","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1002\/hep.23783","article-title":"Biliary apotopes and anti-mitochondrial antibodies activate innate immune responses in primary biliary cirrhosis","volume":"52","author":"Lleo","year":"2010","journal-title":"Hepatology"},{"key":"R47-20250611","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1002\/hep.22736","article-title":"Apotopes and the biliary specificity of primary biliary cirrhosis","volume":"49","author":"Lleo","year":"2009","journal-title":"Hepatology"},{"key":"R48-20250611","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/S0140-6736(10)61965-4","article-title":"Primary biliary cirrhosis","volume":"377","author":"Selmi","year":"2011","journal-title":"Lancet"},{"key":"R49-20250611","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJM198301063080101","article-title":"The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis","volume":"6","author":"Roll","year":"1983","journal-title":"N Engl J Med"},{"key":"R50-20250611","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/hep.1840100102","article-title":"Prognosis in primary biliary cirrhosis: model for decision making","volume":"10","author":"Dickson","year":"1989","journal-title":"Hepatology"},{"key":"R52-20250611","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1053\/gast.2002.36027","article-title":"Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years","volume":"123","author":"Prince","year":"2002","journal-title":"Gastroenterology"},{"key":"R53-20250611","first-page":"61","article-title":"Natural history and management of primary biliary cirrhosis","volume":"4","author":"Al-Harthy","year":"2012","journal-title":"Hepat Med"},{"key":"R54-20250611","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.jhep.2009.11.027","article-title":"Primary biliary cirrhosis: a 2010 update","volume":"52","author":"Poupon","year":"2010","journal-title":"J Hepatol"},{"key":"R55-20250611","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1053\/cgh.2003.50014","article-title":"When is liver biopsy needed in the diagnosis of primary biliary cirrhosis?","volume":"1","author":"Zein","year":"2003","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R56-20250611","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/j.1365-2036.2012.05223.x","article-title":"Review article: overlap syndromes and autoimmune liver disease","volume":"36","author":"Trivedi","year":"2012","journal-title":"Aliment Pharmacol Ther"},{"key":"R57-20250611","first-page":"225","article-title":"Autoantibodies and liver disease: uses and abuses","volume":"24","author":"Zeman","year":"2010","journal-title":"Can J Gastroenterol"},{"key":"R58-20250611","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1002\/hep.510250507","article-title":"Comparison of the clinical features and clinical course of antimitochondrial antibody- positive and -negative primary biliary cirrhosis","volume":"25","author":"Invernizzi","year":"1997","journal-title":"Hepatology"},{"key":"R59-20250611","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1515\/cclm-2013-0926","article-title":"The accuracy of the anti-mitochondrial antibody and the M2 subtype test for diagnosis of primary biliary cirrhosis: a meta-analysis","volume":"52","author":"Hu","year":"2014","journal-title":"Clin Chem Lab Med"},{"key":"R60-20250611","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1046\/j.1440-1746.2002.02700.x","article-title":"Automated enzymatic mitochondrial antibody assay for the diagnosis of primary biliary cirrhosis: applications of a routine diagnostic tool for the detection of antimitochondrial antibodies","volume":"17","author":"Hazama","year":"2002","journal-title":"J Gastroenterol Hepatol"},{"key":"R61-20250611","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1515\/cclm-2017-0249","article-title":"The diagnostic accuracy of biomarkers for diagnosis of primary biliary cholangitis (PBC) in anti-mitochondrial antibody (AMA)-negative PBC patients: a review of literature","volume":"56","author":"de Liso","year":"2017","journal-title":"Clin Chem Lab Med"},{"key":"R62-20250611","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1002\/hep.21151","article-title":"Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC","volume":"43","author":"Corpechot","year":"2006","journal-title":"Hepatology"},{"key":"R63-20250611","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1002\/hep.23584","article-title":"Diagnosis and management of autoimmune hepatitis","volume":"51","author":"Manns","year":"2010","journal-title":"Hepatology"},{"key":"R64-20250611","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/hep.510280203","article-title":"Primary biliary cirrhosisautoimmune hepatitis overlap syndrome: clinical features and response to therapy","volume":"28","author":"Chazouilleres","year":"1998","journal-title":"Hepatology"},{"key":"R65-20250611","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/ajg.2009.616","article-title":"Autoimmune hepatitis-PBC overlap syndrome: a simplified scoring system may assist in the diagnosis","volume":"105","author":"Neuhauser","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"R66-20250611","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1111\/j.1572-0241.2007.01136.x","article-title":"Overlap of autoimmune hepatitis and primary biliary cirrhosis: long-term outcomes","volume":"102","author":"Silveira","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"R67-20250611","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s12016-015-8516-5","article-title":"The natural history and prognosis of primary biliary cirrhosis with clinical features of autoimmune hepatitis","volume":"50","author":"Yang","year":"2016","journal-title":"Clin Rev Allergy Immunol"},{"key":"R68-20250611","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.cgh.2013.09.021","article-title":"Factors associated with response to therapy and outcome of patients with primary biliary cirrhosis with features of autoimmune hepatitis","volume":"12","author":"Ozaslan","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R69-20250611","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1136\/gut.22.2.136","article-title":"Is mitochondrial antibody diagnostic of primary biliary cirrhosis?","volume":"22","author":"Munoz","year":"1981","journal-title":"Gut"},{"key":"R70-20250611","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1002\/hep.1840060609","article-title":"Positive antimitochondrial antibody but normal alkaline phosphatase: is this primary biliary cirrhosis?","volume":"6","author":"Mitchison","year":"1986","journal-title":"Hepatology"},{"key":"R71-20250611","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1002\/hep.26909","article-title":"Pruritus in cholestasis: facts and fiction","volume":"60","author":"Beuers","year":"2014","journal-title":"Hepatology"},{"key":"R72-20250611","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1136\/flgastro-2015-100618","article-title":"A systematic approach to the management of cholestatic pruritus in primary biliary cirrhosis","volume":"7","author":"Hegade","year":"2016","journal-title":"Frontline Gastroenterol"},{"key":"R73-20250611","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1002\/hep.23821","article-title":"The potent bile acid sequestrant colesevelam is not effective in cholestatic pruritus: results of a double-blind, randomized, placebo-controlled trial","volume":"52","author":"Kuiper","year":"2010","journal-title":"Hepatology"},{"key":"R74-20250611","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/hep.22906","article-title":"Primary biliary cirrhosis","volume":"50","author":"Lindor","year":"2009","journal-title":"Hepatology"},{"key":"R75-20250611","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1007\/BF01311724","article-title":"Increased incidence of hypothyroidism in primary biliary cirrhosis","volume":"28","author":"Elta","year":"1983","journal-title":"Dig Dis Sci"},{"key":"R76-20250611","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/00002820-199502000-00004","article-title":"Fatigue-reducing strategies used by patients receiving treatment for cancer","volume":"18","author":"Graydon","year":"1995","journal-title":"Cancer Nurs"},{"key":"R77-20250611","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1007\/s10620-008-0613-3","article-title":"Modafinil in the treatment of debilitating fatigue in primary biliary cirrhosis: a clinical experience","volume":"54","author":"Ian Gan","year":"2009","journal-title":"Dig Dis Sci"},{"key":"R78-20250611","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/0016-5085(86)90972-8","article-title":"Azathioprine and prognosis in primary biliary cirrhosis","volume":"90","author":"Christensen","year":"1986","journal-title":"Gastroenterology"},{"key":"R79-20250611","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/0016-5085(80)90571-5","article-title":"Clinical pattern and course of disease in primary biliary cirrhosis based on an analysis of 236 patients","volume":"78","author":"Christensen","year":"1980","journal-title":"Gastroenterology"},{"key":"R80-20250611","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/S0168-8278(05)80139-4","article-title":"Primary biliary cirrhosis: survival of a large cohort of symptomatic and asymptomatic patients followed for 24 years","volume":"20","author":"Mahl","year":"1994","journal-title":"J Hepatol"},{"key":"R81-20250611","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1053\/j.gastro.2015.07.061","article-title":"Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy","volume":"149","author":"Lammers","year":"2015","journal-title":"Gastroenterology"},{"key":"R82-20250611","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1016\/j.jhep.2014.01.029","article-title":"Optimising risk stratification in primary biliary cirrhosis: AST\/platelet ratio index predicts outcome independent of ursodeoxycholic acid response","volume":"60","author":"Trivedi","year":"2014","journal-title":"J Hepatol"},{"key":"R83-20250611","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1002\/hep.510230108","article-title":"Time course of histological progression in primary biliary cirrhosis","volume":"23","author":"Locke","year":"1996","journal-title":"Hepatology"},{"key":"R84-20250611","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.jhep.2011.02.031","article-title":"Early primary biliary cirrhosis: biochemical response to treatment and prediction of long-term outcome","volume":"55","author":"Corpechot","year":"2011","journal-title":"J Hepatol"},{"key":"R85-20250611","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1038\/nrgastro.2015.187","article-title":"Primary biliary cirrhosis: renaming primary biliary cirrhosis-clarity or confusion?","volume":"12","author":"Trivedi","year":"2015","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"R86-20250611","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1038\/ajg.2017.440","article-title":"Major hepatic complications in ursodeoxycholic acid-treated patients with primary biliary cholangitis: risk factors and time trends in incidence and outcome","volume":"113","author":"Harms","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"R87-20250611","first-page":"467","article-title":"Variceal bleeding is associated with reduced risk of severe cholestasis in primary biliary cirrhosis","volume":"71","author":"Thornton","year":"1989","journal-title":"Q J Med"},{"key":"R88-20250611","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1002\/hep.1840200617","article-title":"Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis","volume":"20","author":"Boyer","year":"1994","journal-title":"Hepatology"},{"key":"R89-20250611","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/0016-5085(92)90771-P","article-title":"Nodular regenerative hyperplasia of the liver in early histological stages of primary biliary cirrhosis","volume":"102","author":"Colina","year":"1992","journal-title":"Gastroenterology"},{"key":"R90-20250611","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1053\/j.gastro.2009.01.003","article-title":"Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxycholic acid","volume":"136","author":"Kuiper","year":"2009","journal-title":"Gastroenterology"},{"key":"R91-20250611","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1053\/j.gastro.2005.12.029","article-title":"Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid","volume":"130","author":"Par\u00e9s","year":"2006","journal-title":"Gastroenterology"},{"key":"R92-20250611","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1002\/hep.22428","article-title":"Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis","volume":"48","author":"Corpechot","year":"2008","journal-title":"Hepatology"},{"key":"R93-20250611","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1038\/ajg.2010.216","article-title":"Baseline ductopenia and treatment response predict long-term histological progression in primary biliary cirrhosis","volume":"105","author":"Kumagi","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"R94-20250611","doi-asserted-by":"crossref","first-page":"e116","DOI":"10.1038\/ctg.2017.43","article-title":"Epidemiology and natural history of primary biliary cholangitis in the Chinese: a territory-based study in Hong Kong between 2000 and 2015","volume":"8","author":"Cheung","year":"2017","journal-title":"Clin Transl Gastroenterol"},{"key":"R95-20250611","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1002\/hep.23095","article-title":"Incidence, risk factors, and survival of hepatocellular carcinoma in primary biliary cirrhosis: comparative analysis from two centers","volume":"50","author":"Cavazza","year":"2009","journal-title":"Hepatology"},{"key":"R96-20250611","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1002\/hep.25788","article-title":"Primary biliary cirrhosis and cancer risk: a systematic review and meta-analysis","volume":"56","author":"Liang","year":"2012","journal-title":"Hepatology"},{"key":"R97-20250611","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1002\/hep.26176","article-title":"Incidence of and risk factors for hepatocellular carcinoma in primary biliary cirrhosis: national data from Japan","volume":"57","author":"Harada","year":"2013","journal-title":"Hepatology"},{"key":"R98-20250611","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/gutjnl-2014-308351","article-title":"Stratification of hepatocellular carcinoma risk in primary biliary cirrhosis: a multicentre international study","volume":"65","author":"Trivedi","year":"2006","journal-title":"Gut"},{"key":"R99-20250611","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1002\/hep.22458","article-title":"Surveillance for hepatocellular carcinoma in patients with primary biliary cirrhosis","volume":"48","author":"Silveria","year":"2008","journal-title":"Hepatology"},{"key":"R100-20250611","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/S0168-8278(01)00144-1","article-title":"Bone disease in primary biliary cirrhosis: independent indicators and rate of progression","volume":"35","author":"Menon","year":"2001","journal-title":"J Hepatol"},{"key":"R101-20250611","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1053\/j.gastro.2006.09.012","article-title":"Fracture risk in people with primary biliary cirrhosis: a population-based cohort study","volume":"131","author":"Solaymani-Dodaran","year":"2006","journal-title":"Gastroenterology"},{"key":"R102-20250611","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jhep.2004.11.035","article-title":"Severity of cholestasis and advanced histological stage but not menopausal status are the major risk factors for osteoporosis in primary biliary cirrhosis","volume":"42","author":"Gua\u00f1abens","year":"2005","journal-title":"J Hepatol"},{"key":"R103-20250611","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1002\/hep.20866","article-title":"Alendronate improves bone mineral density in primary biliary cirrhosis: a randomized placebo-controlled trial","volume":"42","author":"Zein","year":"2005","journal-title":"Hepatology"},{"key":"R104-20250611","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1002\/hep.26466","article-title":"Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with primary biliary cirrhosis","volume":"58","author":"Gua\u00f1abens","year":"2013","journal-title":"Hepatology"},{"key":"R105-20250611","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/j.1478-3231.2005.01026.x","article-title":"Raloxifene improves bone mass in osteopenic women with primary biliary cirrhosis: results of a pilot study","volume":"25","author":"Levy","year":"2005","journal-title":"Liver Int"},{"key":"R106-20250611","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/00004836-199504000-00011","article-title":"Serum lipid and fat-soluble vitamin levels in primary sclerosing cholangitis","volume":"20","author":"Jorgensen","year":"1995","journal-title":"J Clin Gastroenterol"},{"key":"R107-20250611","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1136\/gut.51.2.265","article-title":"Hyperlipidaemic state and cardiovascular risk in primary biliary cirrhosis","volume":"51","author":"Longo","year":"2002","journal-title":"Gut"},{"key":"R108-20250611","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.atherosclerosis.2006.08.060","article-title":"Corneal arcus as coronary artery disease risk factor","volume":"193","author":"Fern\u00e1ndez","year":"2007","journal-title":"Atherosclerosis"},{"key":"R109-20250611","doi-asserted-by":"crossref","first-page":"2116","DOI":"10.1194\/jlr.M400229-JLR200","article-title":"Lipoprotein-X reduces LDL atherogenicity in primary biliary cirrhosis by preventing LDL oxidation","volume":"45","author":"Chang","year":"2004","journal-title":"J Lipid Res"},{"key":"R110-20250611","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1136\/gut.2005.079814","article-title":"Hypercholesterolaemia is not associated with early atherosclerotic lesions in primary biliary cirrhosis","volume":"55","author":"Allocca","year":"2006","journal-title":"Gut"},{"key":"R111-20250611","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.atherosclerosis.2009.08.052","article-title":"Low-dose atorvastatin improves dyslipidemia and vascular function in patients with primary biliary cirrhosis after one year of treatment","volume":"209","author":"Stojakovic","year":"2010","journal-title":"Atherosclerosis"},{"key":"R112-20250611","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1111\/liv.12191","article-title":"Randomized controlled trial assessing the effect of simvastatin in primary biliary cirrhosis","volume":"33","author":"Cash","year":"2013","journal-title":"Liver Int"},{"key":"R113-20250611","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/j.cgh.2017.04.039","article-title":"Statin use and risk of cirrhosis and related complications in patients with chronic liver diseases: a systematic review and meta-analysis","volume":"15","author":"Kim","year":"2017","journal-title":"Clin Gastro Hepatol"},{"key":"R114-20250611","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.1111\/j.1572-0241.2001.04134.x","article-title":"Fat-soluble vitamin levels in patients with primary biliary cirrhosis","volume":"96","author":"Phillips","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"R115-20250611","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.clinre.2011.02.007","article-title":"Liver transplantation in PBC and PSC: indications and disease recurrence","volume":"35","author":"Carbone","year":"2011","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"R116-20250611","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1002\/lt.20511","article-title":"Recurrent primary biliary cirrhosis: peritransplant factors and ursodeoxycholic acid treatment post-liver transplant","volume":"11","author":"Guy","year":"2005","journal-title":"Liver Transpl"},{"key":"R117-20250611","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/lt.20123","article-title":"Immunosuppression affects the rate of recurrent primary biliary cirrhosis after liver transplantation","volume":"10","author":"Neuberger","year":"2004","journal-title":"Liver Transpl"},{"key":"R118-20250611","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/ajt.12132","article-title":"Calcineurin inhibitors and the IL12A locus influence risk of recurrent primary biliary cirrhosis after liver transplantation","volume":"13","author":"Carbone","year":"2013","journal-title":"Am J Transplant"},{"key":"R119-20250611","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1016\/j.jhep.2015.07.038","article-title":"Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence","volume":"63","author":"Bosch","year":"2015","journal-title":"J Hepatol"},{"key":"R120-20250611","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1002\/lt.21124","article-title":"Long-term survival and impact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantation","volume":"13","author":"Charatcharoenwitthaya","year":"2007","journal-title":"Liver Transpl"},{"key":"R121-20250611","doi-asserted-by":"crossref","first-page":"S234","DOI":"10.1016\/S0168-8278(18)30686-X","article-title":"Factors associated with potential progressive course of primary biliary cholangitis: data from a cross-sectional analysis of a large real-world U.S","volume":"68","author":"Younossi","year":"2018","journal-title":"Database J Hepatol"},{"key":"R122-20250611","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/S0016-5085(76)80250-8","article-title":"A prospective controlled trial of azathioprine in primary biliary cirrhosis","volume":"70","author":"Heathcote","year":"1976","journal-title":"Gastroenterology"},{"key":"R123-20250611","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/0168-8278(92)90065-W","article-title":"A controlled trial of prednisolone treatment in primary biliary cirrhosis. Three-year results","volume":"15","author":"Mitchison","year":"1992","journal-title":"J Hepatol"},{"key":"R124-20250611","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/0016-5085(93)90422-9","article-title":"Cyclosporin A treatment in primary biliary cirrhosis: results of a long-term placebo controlled trial","volume":"104","author":"Lombard","year":"1993","journal-title":"Gastroenterology"},{"key":"R125-20250611","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1016\/S0016-5085(99)70403-8","article-title":"A prospective trial of colchicine and methotrexate in the treatment of primary biliary cirrhosis","volume":"117","author":"Kaplan","year":"1999","journal-title":"Gastroenterology"},{"key":"R126-20250611","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1056\/NEJM199405123301903","article-title":"Ursodiol for the long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group","volume":"330","author":"Poupon","year":"1994","journal-title":"N Engl J Med"},{"key":"R127-20250611","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1002\/hep.1840140527","article-title":"Conjugates of ursodeoxycholate protect against cytotoxicity of more hydrophobic bile salts: in vitro studies in rat hepatocytes and human erythrocytes","volume":"14","author":"Heuman","year":"1991","journal-title":"Hepatology"},{"key":"R128-20250611","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1002\/hep.510290618","article-title":"Biliary bile acids in primary biliary cirrhosis: effect of ursodeoxycholic acid","volume":"29","author":"Combes","year":"1999","journal-title":"Hepatology"},{"key":"R129-20250611","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/S0140-6736(87)91610-2","article-title":"Is ursodeoxycholic acid an effective treatment for primary biliary cirrhosis?","volume":"1","author":"Poupon","year":"1987","journal-title":"Lancet"},{"key":"R130-20250611","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1056\/NEJM199405123301903","article-title":"Ursodiol for the long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group","volume":"330","author":"Poupon","year":"1994","journal-title":"N Engl J Med"},{"key":"R131-20250611","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1056\/NEJMoa1509840","article-title":"A placebo-controlled trial of obeticholic acid in primary biliary cholangitis","volume":"18","author":"Nevens","year":"2016","journal-title":"N Engl J Med"},{"key":"R132-20250611","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1053\/j.gastro.2015.07.061","article-title":"Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy","volume":"149","author":"Lammers","year":"2015","journal-title":"Gastroenterology"},{"key":"R133-20250611","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1053\/j.gastro.2014.08.029","article-title":"Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: an international follow-up study","volume":"147","author":"Lammers","year":"2014","journal-title":"Gastroenterology"},{"key":"R134-20250611","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/MOG.0b013e32834452c8","article-title":"Farnesoid X receptor agonists for primary biliary cirrhosis","volume":"27","author":"Lindor","year":"2011","journal-title":"Curr Opin Gastroenterol"},{"key":"R135-20250611","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.apsb.2015.01.005","article-title":"Farnesoid X receptor, the bile acid sensing nuclear receptor, in liver regeneration","volume":"5","author":"Guodong","year":"2015","journal-title":"Acta Pharm Sin B"},{"key":"R136-20250611","doi-asserted-by":"crossref","first-page":"3569","DOI":"10.1021\/jm025529g","article-title":"6-alpha-ethyl-chenodeoxycholic acid (6-ECDCA), a potent and selective FXR agonist endowed with anticholestatic activity","volume":"45","author":"Pellicciari","year":"2002","journal-title":"J Med Chem"},{"key":"R138-20250611","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1002\/hep.28932","article-title":"Long-term clinical impact and cost-effectiveness of obeticholic acid for the treatment of primary biliary cholangitis","volume":"65","author":"Samur","year":"2017","journal-title":"Hepatology"},{"key":"R139-20250611","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.hepres.2004.04.001","article-title":"Prospective randomized crossover trial of combination therapy with bezafibrate and UDCA for primary biliary cirrhosis","volume":"29","author":"Itakura","year":"2004","journal-title":"Hepatol Res"},{"key":"R140-20250611","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/j.1872-034X.2007.00305.x","article-title":"The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis: a prospective, multicenter study","volume":"38","author":"Iwasaki","year":"2008","journal-title":"Hepatol Res"},{"key":"R141-20250611","doi-asserted-by":"crossref","first-page":"S89","DOI":"10.1016\/S0168-8278(17)30442-7","article-title":"A 2-year multicenter, double-blind, randomized, placebo-controlled study of bezafibrate for the treatment of primary biliary cholangitis in patients with inadequate biochemical response to ursodeoxycholic acid therapy (Bezurso)","volume":"66","author":"Corpechot","year":"2017","journal-title":"J Hepatol"},{"key":"R144-20250611","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/j.1478-3231.1999.tb00020.x","article-title":"Utilization of the Mayo risk score in patients with primary biliary cirrhosis receiving ursodeoxycholic acid","volume":"19","author":"Angulo","year":"1999","journal-title":"Liver"},{"key":"R145-20250611","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1007\/s00535-009-0051-9","article-title":"Early biochemical response to ursodeoxycholic acid predicts symptom development in patients with asymptomatic primary biliary cirrhosis","volume":"44","author":"Azemoto","year":"2009","journal-title":"J Gastroenterol"}],"container-title":["American Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.nature.com\/articles\/s41395-018-0390-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.nature.com\/articles\/s41395-018-0390-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/00000434-201901000-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/www.nature.com\/articles\/s41395-018-0390-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:59:26Z","timestamp":1786543166000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00000434-201901000-00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":140,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1038\/s41395-018-0390-3","relation":{},"ISSN":["0002-9270","1572-0241"],"issn-type":[{"value":"0002-9270","type":"print"},{"value":"1572-0241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]},"assertion":[{"value":"2018-08-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}