Why Doesn't Primary Biliary Cholangitis Respond to Immunosuppressive Medications?

Antonio Molinaro; Hanns-Ulrich Marschall

doi:10.1007/s11901-017-0345-y

Why Doesn't Primary Biliary Cholangitis Respond to Immunosuppressive Medications?

Curr Hepatol Rep. 2017;16(2):119-123. doi: 10.1007/s11901-017-0345-y. Epub 2017 Apr 27.

Authors

Antonio Molinaro¹, Hanns-Ulrich Marschall¹

Affiliation

¹ Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, SE-413 45 Gothenburg, Sweden.

Abstract

Purpose of review: The purpose of this review is to discuss reasons why immunosuppressive therapy so far failed in Primary Biliry Cholangitis.

Recent findings: Even targeted immunosuppressive therapy seems ineffective or potentially harmful.

Summary: Bile acid-mediated cholangiocyte damage, facilitated by insufficient bicarbonate secretion, seems to attenuate the anti-inflammatory and anti-fibrotic actions of immunosuppressant and immunomodulatory drugs in a clinically significant way.

Keywords: AMA; Bicarbonate; Cholestasis; Immunosuppression; OCA; PBC; UDCA.

Publication types

Review