Reviewer's report
Title:The occurrence of Urinary Tract Infection before development of Primary
Biliary Cirrhosis: a case control study.
Version: 1Date:10 March 2011
Reviewer: Dimitrios Bogdanos
Reviewer's report:
The report by Varyani et al determined whether urinary tract infections are more
common in patients with primary biliary cirrhosis (PBC) prior to the diagnosis of
the disease compared to controls with chronic liver disease. Their case control
study is based on the UK General Practice Research Database (GPRD). These
findings will help the ongoing debate as to whether urinary tract infection has a
causal or casual relationship with this disease.
Their findings indicate that PBC is associated with UTI prior to diagnosis and that
this association is stronger in younger PBC patients. Thus, it appears that in PBC
patients before the age of 55, 31% had a prior diagnosis of UTI compared to 20%
of age and sex matched controls.
The study is of interest. My view is that such methodological studies are needed
to better understand the association of risk factors such as urinary tract infections
or smoking with the development of PBC or other autoimmune liver diseases.
Major point
The Authors need to make clear that one of the limitation of their studies was that
the control population of patients with chronic liver diseases was predominantly a
population of male patients (60%) when that of PBC is strikingly a female
population. Also, the control population with patients with chronic liver diseases
was younger than that of PBC. These differences clearly affect the results given
in cohorts not adjusted for age and sex as urinary tract infection is likely to be
more frequent in older women.
Minor Points
The Authors need to give more details/brief description of the GPRD and a link to
its website. The must also make clear in the abstract and methodology that
GPRD is a UK database.
Several original and review articles discussing the role of E.coli infection in PBC
and molecular mimicry studies involving E. coli and PBC-specific autoantigens
are missing and should be included Dis Markers. 2010;29(6):301-11; Clin Rev
Allergy Immunol. 2011 Feb 22; Clin Rev Allergy Immunol. 2009 Feb;36(1):30-9;
Dig Liver Dis. 2003 Nov;35(11):801-5; J Hepatol. 2004 Jan;40(1):31-9.
Page 13, Discussion 268 & 269, it is molecular mimicry ...instead of .... molecular
mimickery
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:The occurrence of Urinary Tract Infection before development of Primary
Biliary Cirrhosis: a case control study.
Version: 1Date:10 March 2011
Reviewer: Dimitrios Bogdanos
Reviewer's report:
The report by Varyani et al determined whether urinary tract infections are more
common in patients with primary biliary cirrhosis (PBC) prior to the diagnosis of
the disease compared to controls with chronic liver disease. Their case control
study is based on the UK General Practice Research Database (GPRD). These
findings will help the ongoing debate as to whether urinary tract infection has a
causal or casual relationship with this disease.
Their findings indicate that PBC is associated with UTI prior to diagnosis and that
this association is stronger in younger PBC patients. Thus, it appears that in PBC
patients before the age of 55, 31% had a prior diagnosis of UTI compared to 20%
of age and sex matched controls.
The study is of interest. My view is that such methodological studies are needed
to better understand the association of risk factors such as urinary tract infections
or smoking with the development of PBC or other autoimmune liver diseases.
Major point
The Authors need to make clear that one of the limitation of their studies was that
the control population of patients with chronic liver diseases was predominantly a
population of male patients (60%) when that of PBC is strikingly a female
population. Also, the control population with patients with chronic liver diseases
was younger than that of PBC. These differences clearly affect the results given
in cohorts not adjusted for age and sex as urinary tract infection is likely to be
more frequent in older women.
Minor Points
The Authors need to give more details/brief description of the GPRD and a link to
its website. The must also make clear in the abstract and methodology that
GPRD is a UK database.
Several original and review articles discussing the role of E.coli infection in PBC
and molecular mimicry studies involving E. coli and PBC-specific autoantigens
are missing and should be included Dis Markers. 2010;29(6):301-11; Clin Rev
Allergy Immunol. 2011 Feb 22; Clin Rev Allergy Immunol. 2009 Feb;36(1):30-9;
Dig Liver Dis. 2003 Nov;35(11):801-5; J Hepatol. 2004 Jan;40(1):31-9.
Page 13, Discussion 268 & 269, it is molecular mimicry ...instead of .... molecular
mimickery
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:The occurrence of Urinary Tract Infection before development of Primary
Biliary Cirrhosis: a case control study.
Version: 1Date:10 March 2011
Reviewer: Dimitrios Bogdanos
Reviewer's report:
The report by Varyani et al determined whether urinary tract infections are more
common in patients with primary biliary cirrhosis (PBC) prior to the diagnosis of
the disease compared to controls with chronic liver disease. Their case control
study is based on the UK General Practice Research Database (GPRD). These
findings will help the ongoing debate as to whether urinary tract infection has a
causal or casual relationship with this disease.
Their findings indicate that PBC is associated with UTI prior to diagnosis and that
this association is stronger in younger PBC patients. Thus, it appears that in PBC
patients before the age of 55, 31% had a prior diagnosis of UTI compared to 20%
of age and sex matched controls.
The study is of interest. My view is that such methodological studies are needed
to better understand the association of risk factors such as urinary tract infections
or smoking with the development of PBC or other autoimmune liver diseases.
Major point
The Authors need to make clear that one of the limitation of their studies was that
the control population of patients with chronic liver diseases was predominantly a
population of male patients (60%) when that of PBC is strikingly a female
population. Also, the control population with patients with chronic liver diseases
was younger than that of PBC. These differences clearly affect the results given
in cohorts not adjusted for age and sex as urinary tract infection is likely to be
more frequent in older women.
Minor Points
The Authors need to give more details/brief description of the GPRD and a link to
its website. The must also make clear in the abstract and methodology that
GPRD is a UK database.
Several original and review articles discussing the role of E.coli infection in PBC
and molecular mimicry studies involving E. coli and PBC-specific autoantigens
are missing and should be included Dis Markers. 2010;29(6):301-11; Clin Rev
Allergy Immunol. 2011 Feb 22; Clin Rev Allergy Immunol. 2009 Feb;36(1):30-9;
Dig Liver Dis. 2003 Nov;35(11):801-5; J Hepatol. 2004 Jan;40(1):31-9.
Page 13, Discussion 268 & 269, it is molecular mimicry ...instead of .... molecular
mimickery
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
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