New article published: Karemera et al, 2023


Congratulations to Dr. Karemera and colleagues on the publication in the Journal of Pediatric Gastroenterology and Nutrition Reports of their article on the efficacy of metronidazole treatment in autoimmune sclerosing cholangitis. We are proud to have contributed to the success of this article.

𝐀𝐮𝐭𝐨𝐢𝐦𝐦𝐮𝐧𝐞 𝐬𝐜𝐥𝐞𝐫𝐨𝐬𝐢𝐧𝐠 𝐜𝐡𝐨𝐥𝐚𝐧𝐠𝐢𝐭𝐢𝐬, which occurs mainly in children and young adults, is characterized by an 𝐨𝐯𝐞𝐫𝐥𝐚𝐩 𝐨𝐟 𝐟𝐞𝐚𝐭𝐮𝐫𝐞𝐬 characteristic of 𝐚𝐮𝐭𝐨𝐢𝐦𝐦𝐮𝐧𝐞 𝐡𝐞𝐩𝐚𝐭𝐢𝐭𝐢𝐬 (HA) and 𝐩𝐫𝐢𝐦𝐚𝐫𝐲 𝐬𝐜𝐥𝐞𝐫𝐨𝐬𝐢𝐧𝐠 𝐜𝐡𝐨𝐥𝐚𝐧𝐠𝐢𝐭𝐢𝐬 (PSC). This pathology is often associated with inflammatory bowel disease, such as ulcerative colitis, and the interaction between intestinal microbiota and bile acids may be involved in its mechanism.

The use of 𝐚𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜𝐬 to treat this pathology is innovative. The authors studied the efficacy of 𝐦𝐞𝐭𝐫𝐨𝐧𝐢𝐝𝐚𝐳𝐨𝐥𝐞 𝐭𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 in patients with HA or PSC, divided into groups of patients in remission or relapse. After metronidazole treatment, plasma levels of C-reactive protein, transaminases, and gamma-glutamyl transferase were reduced in both groups, reflecting an 𝐢𝐦𝐩𝐫𝐨𝐯𝐞𝐦𝐞𝐧𝐭 𝐢𝐧 𝐭𝐡𝐞𝐢𝐫 𝐜𝐨𝐧𝐝𝐢𝐭𝐢𝐨𝐧. An increase in hydrophilic bile acids was noted in the plasma of patients in remission. 𝐍𝐨 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞𝐬 𝐢𝐧 𝐦𝐢𝐜𝐫𝐨𝐛𝐢𝐨𝐭𝐚 𝐜𝐨𝐦𝐩𝐨𝐬𝐢𝐭𝐢𝐨𝐧 were observed during the study.

These data indicate the potential 𝐥𝐨𝐧𝐠-𝐭𝐞𝐫𝐦 𝐞𝐟𝐟𝐞𝐜𝐭𝐬 𝐨𝐟 𝐦𝐞𝐭𝐫𝐨𝐧𝐢𝐝𝐚𝐳𝐨𝐥𝐞 𝐭𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 in patients with HA or PSC, including an increase in hydrophilic bile acids.

The article is already available on the journal's website! DOI: 10.1097/PG9.0000000000000334