中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 35 Issue 2
Feb.  2019
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Article Contents

New therapeutic targets and drugs for cholestatic liver disease

DOI: 10.3969/j.issn.1001-5256.2019.02.005
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  • Published Date: 2019-02-20
  • Cholestatic liver disease is caused by the damage of bile duct cells and hepatocytes due to bile duct injury, accumulation of bile acids, and persistent inflammation. If it is not treated in time, cholestasis can lead to liver fibrosis, liver cirrhosis, and even end-stage liver disease. Primary biliary cholangitis ( PBC) and primary sclerosing cholangitis ( PSC) are the two most common cholestatic liver diseases in adults, with unknown causes. Although ursodeoxycholic acid ( UDCA) can improve the prognosis of PBC patients and prolong survival time after liver transplantation, some patients have no response to UDCA. In addition, there are still no effective pharmacotherapies for PSC.With the research advances in molecular mechanism of bile acid regulation and a deeper understanding of immune pathways in recent years, several new drugs have emerged. This article introduces the new therapeutic targets and drugs for PBC and PSC.

     

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  • [1]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Infectious Diseases, Chinese Medical Association.Consensus on the diagnosis and treatment of cholestasis liver diseases (2015) [J].J Clin Hepatol, 2015, 31 (12) :1989-1999. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会.胆汁淤积性肝病诊断和治疗共识 (2015) [J].临床肝胆病杂志, 2015, 31 (12) :1989-1999.
    [2]BORTOLINI M, ALMASIO P, BRAY G, et al.Multicentre survey of the prevalence of intrahepatic cholestasis in 2520 consecutive patients with newly diagnosed chronic liver disease[J].Drug Investigation, 1992, 4 (Suppl 4) :83-89.
    [3]BEUERS U, TRAUNER M, JANSEN P, et al.New paradigms in the treatment of hepatic cholestasis:From UDCA to FXR, PXRand beyond[J].J Hepatol, 2015, 62 (1 Suppl) :s25-s37.
    [4]SANTIAGO P, SCHEINBERG AR, LEVY C.Cholestatic liver diseases:New targets, new therapies[J].Therap Adv Gastroenterol, 2018, 11:1756284818787400.
    [5]HARMS MH, LAMMERS WJ, THORBURN D, et al.Major hepatic complications in ursodeoxycholic acid-treated patients with primary biliary cholangitis:Risk factors and time trends in incidence and outcome[J].Am J Gastroenterol, 2018, 113 (2) :254-264.
    [6]KARLSEN TH, FOLSERAAS T, THORBURN D, et al.Primary sclerosing cholangitis-a comprehensive review[J].J Hepatol, 2017, 67 (6) :1298-1323.
    [7]LAZARIDIS KN, LARUSSO NF.Primary sclerosing cholangitis[J].N Engl J Med, 2016, 375 (12) :1161-1170.
    [8]OLSSON R, BOBERG KM, de MUCKADELL OS, et al.Highdose ursodeoxycholic acid in primary sclerosing cholangitis:A5-year multicenter, randomized, controlled study[J].Gastroenterology, 2005, 129 (5) :1464-1472.
    [9]LINDOR KD, KOWDLEY KV, LUKETIC VA, et al.High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis[J].Hepatology, 2009, 50 (3) :808-814.
    [10]SHI J, LI Z, ZENG X, et al.Ursodeoxycholic acid in primary sclerosing cholangitis:Meta-analysis of randomized controlled trials[J].Hepatol Res, 2009, 39 (9) :865-873.
    [11]OTHMAN MO, DUNKELBERG J, ROY PK.Urosdeoxycholic acid in primary sclerosing cholangitis:A meta-analysis and systematic review[J].Arab J Gastroenterol, 2012, 13 (3) :103-110.
    [12] TRAUNER M, FUCHS CD, HALILBASIC E, et al.New therapeutic concepts in bile acid transport and signaling for management of cholestasis[J].Hepatology, 2017, 65 (4) :1393-1404.
    [13]de VRIES E, BEUERS U.Management of cholestatic disease in 2017[J].Liver Int, 2017, 37 (Suppl 1) :123-129.
    [14]STEDMAN CA, LIDDLE C, COULTER SA, et al.Nuclear receptors constitutive androstane receptor and pregnane X receptor ameliorate cholestatic liver injury[J].Proc Natl Acad Sci U S A, 2005, 102 (6) :2063-2068.
    [15]TENG S, PIQUETTE-MILLER M.Hepatoprotective role of PXRactivation and MRP3 in cholic acid-induced cholestasis[J].Br JPharmacol, 2007, 151 (3) :367-376.
    [16]HIRSCHFIELD GM, GERSHWIN ME, STRAUSS R, et al.Ustekinumab for patients with primary biliary cholangitis who have an inadequate response to ursodeoxycholic acid:A proof-of-concept study[J].Hepatology, 2016, 64 (1) :189-199.
    [17]DYSON JK, HIRSCHFIELD GM, ADAMS DH, et al.Novel therapeutic targets in primary biliary cirrhosis[J].Nat Rev Gastroenterol Hepatol, 2015, 12 (3) :147-158.
    [18]NEVENS F, ANDREONE P, MAZZELLA G, et al.A placebocontrolled trial of obeticholic acid in primary biliary cholangitis[J].N Engl J Med, 2016, 375 (7) :631-643.
    [19]KOWDLEY KV, LUKETIC V, CHAPMAN R, et al.A randomized trial of obeticholic acid monotherapy in patients with primary biliary cholangitis[J].Hepatology, 2018, 67 (5) :1890-1902.
    [20]LARUSSO NF, BOWLUS CL, LEVY C, et al.PC.01.8 The AESOP trial:A randomized, double-blind, placebo-controlled, phase 2 study of obeticholic acid in patients with primary sclerosing cholangitis[J].Digest Liver Dis, 2018, 50 (2) :e67.
    [21]SAMUR S, KLEBANOFF M, BANKEN R, et al.Long-term clinical impact and cost-effectiveness of obeticholic acid for the treatment of primary biliary cholangitis[J].Hepatology, 2017, 65 (3) :920-928.
    [22]MAYO MJ, WIGG AJ, LEGGETT BA, et al.NGM282 for treatment of patients with primary biliary cholangitis:A multicenter, randomized, double-blind, placebo-controlled trial[J].Hepatol Commun, 2018, 2 (9) :1037-1050.
    [23]CORPECHOT C, CHAZOUILLRES O, ROUSSEAU A, et al.A placebo-controlled trial of bezafibrate in primary biliary cholangitis[J].N Engl J Med, 2018, 378 (23) :2171-2181.
    [24]YIN Q, LI J, XIA Y, et al.Systematic review and meta-analysis:Bezafibrate in patients with primary biliary cirrhosis[J].Drug Des Devel Ther, 2015, 9:5407-5419.
    [25]JONES D, BOUDES PF, SWAIN MG, et al.Seladelpar (MBX-8025) , a selective PPAR-δagonist, in patients with primary biliary cholangitis with an inadequate response to ursodeoxycholic acid:A double-blind, randomised, placebo-controlled, phase2, proof-of-concept study[J].Lancet Gastroenterol Hepatol, 2017, 2 (10) :716-726.
    [26]BOUDES P, MICHAEL G, BOWLUS C, et al.Pharmacokinetics and pharmacodynamics of seladelpar, a potent and selective PPAR-delta, in patients with primary biliary cholangitis[J].J Hepatol, 2018, 68:s105-s364.
    [27]TSUDA M, MORITOKI Y, LIAN ZX, et al.Biochemical and immunologic effects of rituximab in patients with primary biliary cirrhosis and an incomplete response to ursodeoxycholic acid[J].Hepatology, 2012, 55 (2) :512-521.
    [28]MYERS RP, SWAIN MG, LEE SS, et al.B-cell depletion with rituximab in patients with primary biliary cirrhosis refractory to ursodeoxycholic acid[J].Am J Gastroenterol, 2013, 108 (6) :933-941.
    [29]HOMMES DW, ERKELENS W, PONSIOEN C, et al.A doubleblind, placebo-controlled, randomized study of infliximab in primary sclerosing cholangitis[J].J Clin Gastroenterol, 2008, 42 (5) :522-526.
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