Primary Biliary Cholangitis and Primary Sclerosing Cholangitis

Am J Gastroenterol. 2019 Oct;114(10):1593-1605. doi: 10.14309/ajg.0000000000000268.

Abstract

Cholestatic liver diseases encompass a broad spectrum of pathologies, with the core injury occurring at the level of cholangiocytes and progressing to hepatic fibrosis and liver dysfunction. Primary biliary cholangitis and primary sclerosing cholangitis are the most significant progressive cholangiopathies in adults. Although rare, they commonly evolve to liver failure and need for liver transplantation. Despite recent advances in the basic knowledge of these cholangiopathies, the pathogenesis is still elusive. Targeted treatments to prevent disease progression and to preclude malignancy are not yet available. This review will address the general clinical features of both diseases, analyze their commonalities and differences, and provide a state-of-the art overview of the currently available therapeutics.

Publication types

  • Review

MeSH terms

  • Adult
  • Biliary Tract / pathology
  • Chenodeoxycholic Acid / analogs & derivatives
  • Chenodeoxycholic Acid / therapeutic use
  • Cholagogues and Choleretics / therapeutic use*
  • Cholangitis, Sclerosing / complications
  • Cholangitis, Sclerosing / drug therapy*
  • Cholangitis, Sclerosing / epidemiology
  • Cholangitis, Sclerosing / pathology
  • Cholestasis / drug therapy*
  • Cholestasis / epidemiology
  • Cholestasis / etiology
  • Cholestasis / pathology
  • Clinical Trials as Topic
  • Disease Progression
  • Drug Therapy, Combination
  • End Stage Liver Disease / epidemiology
  • End Stage Liver Disease / etiology
  • End Stage Liver Disease / pathology
  • End Stage Liver Disease / prevention & control*
  • Humans
  • Immunologic Factors / therapeutic use*
  • Life Expectancy
  • Prevalence
  • Prognosis
  • Treatment Outcome
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Cholagogues and Choleretics
  • Immunologic Factors
  • obeticholic acid
  • Chenodeoxycholic Acid
  • Ursodeoxycholic Acid