{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:08:18Z","timestamp":1777039698904,"version":"3.51.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>How anti-mitochondrial antibody (AMA) and liver biochemistry levels change in primary biliary cholangitis (PBC) patients treated with ursodeoxycholic acid (UDCA) remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 28-year cohort of 157 PBC patients was conducted. Patients with alkaline phosphatase (Alk-p) levels &amp;gt;1.67\u2009\u00d7 upper limit of normal after 1 year of UDCA treatment were considered nonresponders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, of 157 (mean age: 54.41 years), 136 (86.6%) were female, 51 (32.5%) had cirrhosis, and 128 (81.5%) had detectable AMAs (immunoglobulin G). UDCA nonresponders (n=61) were younger and had higher Alk-p and total bilirubin levels and cirrhosis rates than UDCA responders (n=84). Alk-p levels and cirrhosis were negatively associated with UDCA response. Regardless of cirrhosis and UDCA response, most PBC patients had decreased Alk-p and \u03b3-glutamyltransferase levels at last follow-up (up to 28.73 years) compared with baseline levels. Patients with baseline cirrhosis (2.78 \u00b1 2.56 vs. 6.84 \u00b1 9.00 mg\/dL, <jats:italic>p<\/jats:italic>=0.024) and UDCA nonresponders (2.54 \u00b1 2.19 vs. 4.51 \u00b1 6.99 mg\/dL, <jats:italic>p<\/jats:italic>=0.006) had increased total bilirubin levels while patients without cirrhosis (AST: 91.5 \u00b1 84.5 vs. 58.9 \u00b1 43.7 U\/L, <jats:italic>p<\/jats:italic>&amp;lt;0.001; ALT: 107.3 \u00b1 122.5 vs. 50.7 \u00b1 36.8 U\/L, <jats:italic>p<\/jats:italic>&amp;lt;0.001) and UDCA responders (AST: 83.8 \u00b1 101.3 vs. 45.58 \u00b1 38.42 U\/L, <jats:italic>p<\/jats:italic>=0.014; ALT: 95.10 \u00b1 144.6 vs. 39.12 \u00b1 30.65 U\/L, <jats:italic>p<\/jats:italic>=0.009) had decreased aminotransferase levels. Only UDCA responders had decreased AMA titers from 1 year after UDCA treatment (<jats:italic>p<\/jats:italic>=0.028) until the last follow-up (<jats:italic>p<\/jats:italic>&amp;lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>UDCA responders exhibited decreased AMA titers 1 year after treatment. Regardless of UDCA response, PBC patients showed improved cholestatic features, but only UDCA responders and patients without baseline cirrhosis exhibited attenuated hepatobiliary damage following UDCA treatment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.869018","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T05:50:35Z","timestamp":1652939435000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Anti-Mitochondrial Antibody Titers Decrease Over Time in Primary Biliary Cholangitis Patients With Ursodeoxycholic Acid Therapeutic Response: A Cohort Study Followed Up to 28 Years"],"prefix":"10.3389","volume":"13","author":[{"given":"Ming-Ling","family":"Chang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ting","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tien-Ming","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Yu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiang-Chi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong-Nan","family":"Chien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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":"B2","doi-asserted-by":"publisher","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":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/gut.46.1.121","article-title":"Characterisation of Patients With Primary Biliary Cirrhosis Responding to Long Term Ursodeoxycholic Acid Treatment","volume":"46","author":"Leuschner","year":"2000","journal-title":"Gut"},{"key":"B4","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1053\/j.gastro.2014.12.005","article-title":"Efficacy of Obeticholic Acid in Patients With Primary Biliary Cirrhosis and Inadequate Response to Ursodeoxycholic Acid","volume":"148","author":"Hirschfield","year":"2015","journal-title":"Gastroenterology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S1089-3261(03)00101-6","article-title":"Primary Biliary Cirrhosis\u2013Presentation and Diagnosis","volume":"7","author":"Leuschner","year":"2003","journal-title":"Clin Liver Dis"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-916324","article-title":"Etiology of Primary Biliary Cirrhosis: The Search for the Culprit","volume":"25","author":"Leung","year":"2005","journal-title":"Semin Liver Dis"},{"key":"B7","article-title":"Klinische Bedeutung Der Antimitochondrialen Antik\u00f6rper [Clinical Significance of Antimitochondrial Antibodies]","volume":"115","author":"R\u00fcegg","year":"1985","journal-title":"Schweiz Med Wochenschr"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-007-9092-0","article-title":"Diagnostic Relevance and Clinical Significance of the New Enhanced Performance M2 (MIT3) ELISA for the Detection of IgA and IgG Antimitochondrial Antibodies in Primary Biliary Cirrhosis","volume":"27","author":"Gabeta","year":"2007","journal-title":"J Clin Immunol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199105303242204","article-title":"A Multicenter, Controlled Trial of Ursodiol for the Treatment of Primary Biliary Cirrhosis. 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