{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:45:32Z","timestamp":1783464332046,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T00:00:00Z","timestamp":1645401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Primary sclerosing cholangitis (PSC) and IgG4\u2010related sclerosing cholangitis (IgG4\u2010SC) are chronic fibro\u2010inflammatory immune\u2010mediated hepatobiliary conditions that are challenging to distinguish in a clinical setting. Accurate non\u2010invasive biomarkers for discriminating PSC and IgG4\u2010SC are important to ensure a correct diagnosis, prompt therapy and adequate cancer surveillance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed nuclear magnetic resonance (NMR)\u2010based metabolomic profiling using serum samples collected prospectively from patients with PSC (<jats:italic>n<\/jats:italic>\u00a0=\u00a0100), IgG4\u2010SC (<jats:italic>n<\/jats:italic>\u00a0=\u00a023) and healthy controls (HC; <jats:italic>n<\/jats:italic>\u00a0=\u00a016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariate analysis of the serum metabolome discriminated PSC from IgG4\u2010SC with greater accuracy (AUC 0.95 [95%CI 0.90\u20130.98]) than IgG4 titre (AUC 0.87 [95%CI 0.79\u20130.94]). When inflammatory bowel disease (IBD) was excluded as a comorbid condition (IgG4\u2010SC <jats:italic>n<\/jats:italic>\u00a0=\u00a020, PSC <jats:italic>n<\/jats:italic>\u00a0=\u00a022), the diagnostic AUC increased to 1.0, suggesting that the metabolome differences identified are not a result of the increased prevalence of IBD in PSC relative to IgG4\u2010SC patients. Serum lactate (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001), glucose (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) and glutamine (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) metabolites were increased in IgG4\u2010related disease (IgG4\u2010RD) and IgG4\u2010SC individuals compared to PSC, whereas mobile choline (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05), 3\u2010hydroxybutyric acid (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) and \u2010CH<jats:sub>3<\/jats:sub> lipoprotein resonances (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) were decreased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Taken together, serum metabolomic profiling has the potential to be incorporated as a diagnostic criterion, independent of IgG4 titre, to improve the diagnosis of IgG4\u2010RD and help distinguish IgG4\u2010SC from PSC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15192","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T11:46:25Z","timestamp":1644234385000},"page":"1344-1354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A novel serum metabolomic panel distinguishes <scp>I<\/scp>g<scp>G4<\/scp>\u2010related sclerosing cholangitis from primary sclerosing cholangitis"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-7459","authenticated-orcid":false,"given":"Daniel E.","family":"Radford\u2010Smith","sequence":"first","affiliation":[{"name":"Department of Pharmacology University of Oxford  Oxford UK"},{"name":"Department of Chemistry University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-2464","authenticated-orcid":false,"given":"Emmanuel 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