Biliary Fibrosis Is an Important but Neglected Pathological Feature in Hepatobiliary Disorders: From Molecular Mechanisms to Clinical Implications

    June 2024 in “ Medical Review
    Jinyu Zhao, Ping Yue, Ningning Mi, Matu Li, Wenkang Fu, Xianzhuo Zhang, Long Gao, Mingzhen Bai, Liang Tian, Ningzu Jiang, Ya‐Wen Lu, Haidong Ma, Chunlu Dong, Yong Zhang, Hengwei Zhang, Jinduo Zhang, Yanxian Ren, Azumi Suzuki, Peng Wong, Kiyohito Tanaka, Rungsun Rerknimitr, Henrik Junger, Tan To Cheung, Emmanuel Melloul, Nicolas Demartines, Joseph W. Leung, Jia Yao, Jinqiu Yuan, Yanyan Lin, Hans J. Schlitt, Wenbo Meng
    TLDR Biliary fibrosis is crucial in liver diseases and understanding it can help prevent and treat these conditions.
    The document reviews the significant yet often overlooked role of biliary fibrosis in hepatobiliary disorders, emphasizing its contribution to disease progression. It explores the etiology, pathogenesis, and cellular mechanisms involving cholangiocytes, immune cells, and fibroblasts, as well as the impact of the microbiome. Key signaling pathways like TGF-β and bile acid metabolism are highlighted. The review discusses diagnostic challenges and therapeutic strategies, including liver transplantation, ERCP, and drugs like UDCA and OCA, while noting the lack of specific anti-fibrosis therapies. Clinical trials and potential treatments, such as PPAR agonists and TGF-β1 inhibitors, are examined, underscoring the need for further research to optimize treatment strategies.
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