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Cholestatic liver diseases: new targets, new therapies
Cholestatic liver diseases result from gradual destruction of bile ducts, accumulation of bile acids and self-perpetuation of the inflammatory process leading to damage to cholangiocytes and hepatocytes. If left untreated, cholestasis will lead to fibrosis, biliary cirrhosis, and ultimately end-stag...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109852/ https://www.ncbi.nlm.nih.gov/pubmed/30159035 http://dx.doi.org/10.1177/1756284818787400 |
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author | Santiago, Priscila Scheinberg, Andrew R. Levy, Cynthia |
author_facet | Santiago, Priscila Scheinberg, Andrew R. Levy, Cynthia |
author_sort | Santiago, Priscila |
collection | PubMed |
description | Cholestatic liver diseases result from gradual destruction of bile ducts, accumulation of bile acids and self-perpetuation of the inflammatory process leading to damage to cholangiocytes and hepatocytes. If left untreated, cholestasis will lead to fibrosis, biliary cirrhosis, and ultimately end-stage liver disease. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the two most common chronic cholestatic liver diseases affecting adults, and their etiologies remain puzzling. While treatment with ursodeoxycholic acid (UDCA) has significantly improved outcomes and prolonged transplant-free survival for patients with PBC, treatment options for UDCA nonresponders remain limited. Furthermore, there is no available medical therapy for PSC. With recent advances in molecular biochemistry specifically related to bile acid regulation and understanding of immunologic pathways, novel pharmacologic treatments have emerged. In this review, we discuss the standard of care and emphasize the various emerging treatments for PBC and PSC. |
format | Online Article Text |
id | pubmed-6109852 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-61098522018-08-29 Cholestatic liver diseases: new targets, new therapies Santiago, Priscila Scheinberg, Andrew R. Levy, Cynthia Therap Adv Gastroenterol Review Cholestatic liver diseases result from gradual destruction of bile ducts, accumulation of bile acids and self-perpetuation of the inflammatory process leading to damage to cholangiocytes and hepatocytes. If left untreated, cholestasis will lead to fibrosis, biliary cirrhosis, and ultimately end-stage liver disease. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the two most common chronic cholestatic liver diseases affecting adults, and their etiologies remain puzzling. While treatment with ursodeoxycholic acid (UDCA) has significantly improved outcomes and prolonged transplant-free survival for patients with PBC, treatment options for UDCA nonresponders remain limited. Furthermore, there is no available medical therapy for PSC. With recent advances in molecular biochemistry specifically related to bile acid regulation and understanding of immunologic pathways, novel pharmacologic treatments have emerged. In this review, we discuss the standard of care and emphasize the various emerging treatments for PBC and PSC. SAGE Publications 2018-08-24 /pmc/articles/PMC6109852/ /pubmed/30159035 http://dx.doi.org/10.1177/1756284818787400 Text en © The Author(s), 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Santiago, Priscila Scheinberg, Andrew R. Levy, Cynthia Cholestatic liver diseases: new targets, new therapies |
title | Cholestatic liver diseases: new targets, new therapies |
title_full | Cholestatic liver diseases: new targets, new therapies |
title_fullStr | Cholestatic liver diseases: new targets, new therapies |
title_full_unstemmed | Cholestatic liver diseases: new targets, new therapies |
title_short | Cholestatic liver diseases: new targets, new therapies |
title_sort | cholestatic liver diseases: new targets, new therapies |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109852/ https://www.ncbi.nlm.nih.gov/pubmed/30159035 http://dx.doi.org/10.1177/1756284818787400 |
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