Inflammatory bowel disease comorbid with autoimmune liver disease

The coexistence of inflammatory bowel disease （IBD） and autoimmune liver disease （AILD） has gained increasing attention in clinical practice， and there are significant increases in the prevalence rates of autoimmune hepatitis （AIH）， primary sclerosing cholangitis （PSC）， and AIH-PSC overlap syndrome among the patients with IBD. Several pathogenic mechanisms are shared between IBD and AILDs， including genetic susceptibility， dysregulation of the gut-liver axis， immune imbalance， and abnormal bile acid metabolism. The ECCO guidelines recommend that patients who are suspected of IBD and receive no treatment should undergo a series of liver function tests， including alanine aminotransferase， alkaline phosphatase， gamma-glutamyl transferase， and total serum bilirubin， as well as regular reexaminations during follow-up. While IBD-AILD patients have unique clinical features， there is still a lack of unified diagnosis and treatment guidelines for this comorbidity， and the selection of therapeutic goal often entails a careful balance between the intestinal tract and the liver， requiring interdisciplinary collaboration and combined therapies based on pathogenesis. Future research should focus on the dynamic regulatory networks of the gut-liver axis to develop innovative intervention strategies that ensure both efficacy and safety.