National study shows Indigenous patients with autoimmune liver disease face worse symptoms and outcomes

Press Release

Search for the cause and better treatments continue, researcher says

EDMONTON — First Nations, Métis and Inuit people with primary biliary cholangitis — a debilitating autoimmune liver disease — have more advanced symptoms at diagnosis and worse long-term outcomes than others in Canada, according to research from a nationwide study.

“This autoimmune liver disease joins the collection of other autoimmune diseases with increased frequency and severity in Indigenous peoples, including multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus,” says co-lead author Andrew Mason, hepatologist and professor in the Faculty of Medicine & Dentistry.

“The cause for the increased severity of disease is not clear.”

Primary biliary cholangitis is a chronic illness in which the immune system misfires and attacks the bile ducts in the liver, slowly destroying them. It affects an estimated 318 people per million in Canada. Nine out of 10 patients are female, according to the Canadian Liver Foundation. Early symptoms include fatigue and itchiness, with abdominal pain, swelling, jaundice and other symptoms developing later. There is no cure for the disease, although treatments can slow its progression. Some patients eventually experience liver failure and require a transplant.

The research team found that Indigenous patients were more likely to develop complications such as deteriorated liver function or liver cancer before diagnosis than new patients from other ethnic groups, even though they were diagnosed at about the same age. Indigenous patients also had persistently poorer results on blood tests even after treatment.

Mason notes that primary biliary cholangitis can be hard to diagnose because it mimics other liver conditions. As with other autoimmune disorders, it appears that a combination of factors lead to the disease, including an underlying genetic risk and environmental triggers such as infection or hormones.

“The link with worse disease in Indigenous populations may be related to an increased genetic risk compared with other Canadians,” Mason says.

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To speak with Andrew Mason about his study, please contact:

Debra Clark
U of A communications associate


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