中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 42 Issue 3
Mar.  2026
Turn off MathJax
Article Contents

Mechanism of ductular reaction and related treatment strategies

DOI: 10.12449/JCH260332
Research funding:

Natural Science Foundation of Sichuan (2025ZNSFSC1902)

More Information
  • Corresponding author: TANG Shanhong, shanhongtang@163.com (ORCID: 0000-0001-6652-2942)
  • Received Date: 2025-07-04
  • Accepted Date: 2025-09-17
  • Published Date: 2026-03-25
  • Ductular reaction (DR) refers to the adaptive pathological changes that occur after hepatobiliary injury, and it is essentially a repair response involving the proliferation, fibrosis, and inflammation of biliary epithelial cell (BEC). With the understanding of the biological function of BEC, the potential value of DR in disease prognosis and treatment has gradually become a research hotspot. This article systematically reviews the molecular mechanism of DR, its potential as a therapeutic target, and future development directions, as well as novel therapies suggested by targeting these molecular mechanisms, in order to provide a new direction for overcoming current bottlenecks in the treatment of bile duct diseases.

     

  • loading
  • [1]
    SORRENTINO G. Microenvironmental control of the ductular reaction: Balancing repair and disease progression[J]. Cell Death Dis, 2025, 16( 1): 246. DOI: 10.1038/s41419-025-07590-4.
    [2]
    HU YH, BAO XY, ZHANG Z, et al. Hepatic progenitor cell-originated ductular reaction facilitates liver fibrosis through activation of hedgehog signaling[J]. Theranostics, 2024, 14( 6): 2379- 2395. DOI: 10.7150/thno.91572.
    [3]
    GUPTA V, SEHRAWAT TS, PINZANI M, et al. Portal fibrosis and the ductular reaction: Pathophysiological role in the progression of liver disease and translational opportunities[J]. Gastroenterology, 2025, 168( 4): 675- 690. DOI: 10.1053/j.gastro.2024.07.044.
    [4]
    KAMIMOTO K, KANEKO K, KOK CY, et al. Heterogeneity and stochastic growth regulation of biliary epithelial cells dictate dynamic epithelial tissue remodeling[J]. eLife, 2016, 5: e15034. DOI: 10.7554/eLife.15034.
    [5]
    ESPAÑOL-SUÑER R, CARPENTIER R, van HUL N, et al. Liver progenitor cells yield functional hepatocytes in response to chronic liver injury in mice[J]. Gastroenterology, 2012, 143( 6): 1564- 1575.e7. DOI: 10.1053/j.gastro.2012.08.024.
    [6]
    SACKETT SD, LI ZD, HURTT R, et al. Foxl1 is a marker of bipotential hepatic progenitor cells in mice[J]. Hepatology, 2009, 49( 3): 920- 929. DOI: 10.1002/hep.22705.
    [7]
    TARLOW BD, PELZ C, NAUGLER WE, et al. Bipotential adult liver progenitors are derived from chronically injured mature hepatocytes[J]. Cell Stem Cell, 2014, 15( 5): 605- 618. DOI: 10.1016/j.stem.2014.09.008.
    [8]
    FONT-BURGADA J, SHALAPOUR S, RAMASWAMY S, et al. Hybrid periportal hepatocytes regenerate the injured liver without giving rise to cancer[J]. Cell, 2015, 162( 4): 766- 779. DOI: 10.1016/j.cell.2015.07.026.
    [9]
    ZHAO JY, LIN YY, YUE P, et al. Pathogenesis, progression and treatment of biliary fibrosis[J]. Chin J Dig Surg, 2024, 23( 7): 989- 1000. DOI: 10.3760/cma.j.cn115610-20240417-00208.

    赵进玉, 林延延, 岳平, 等. 胆道纤维化的发生发展与治疗[J]. 中华消化外科杂志, 2024, 23( 7): 989- 1000. DOI: 10.3760/cma.j.cn115610-20240417-00208.
    [10]
    ZHAO JY, YUE P, MI NN, et al. Biliary fibrosis is an important but neglected pathological feature in hepatobiliary disorders: From molecular mechanisms to clinical implications[J]. Med Rev, 2024, 4( 4): 326- 365. DOI: 10.1515/mr-2024-0029.
    [11]
    BAEK EB, EUN HS, SONG JY, et al. Vitamin D supplementation ameliorates ductular reaction, liver inflammation and fibrosis in mice by upregulating TXNIP in ductular cells[J]. Nat Commun, 2025, 16( 1): 4420. DOI: 10.1038/s41467-025-59724-z.
    [12]
    JIANG XJ, OTTERDAL K, CHUNG BK, et al. Cholangiocytes modulate CD100 expression in the liver and facilitate pathogenic T-helper 17 cell differentiation[J]. Gastroenterology, 2024, 166( 4): 667- 679. DOI: 10.1053/j.gastro.2023.11.283.
    [13]
    GUICCIARDI ME, TRUSSONI CE, LARUSSO NF, et al. The spectrum of reactive cholangiocytes in primary sclerosing cholangitis[J]. Hepatology, 2020, 71( 2): 741- 748. DOI: 10.1002/hep.31067.
    [14]
    CAI XR, TACKE F, GUILLOT A, et al. Cholangiokines: Undervalued modulators in the hepatic microenvironment[J]. Front Immunol, 2023, 14: 1192840. DOI: 10.3389/fimmu.2023.1192840.
    [15]
    HE YH, PAN JX, XU LM, et al. Ductular reaction in non-alcoholic fatty liver disease: When Macbeth is perverted[J]. World J Hepatol, 2023, 15( 6): 725- 740. DOI: 10.4254/wjh.v15.i6.725.
    [16]
    YILDIZ E, ALAM G EL, PERINO A, et al. Hepatic lipid overload triggers biliary epithelial cell activation via E2Fs[J]. eLife, 2023, 12: e81926. DOI: 10.7554/eLife.81926.
    [17]
    ZHENG LH, HAN Y. Personalized diagnosis and treatment strategies for primary biliary cholangitis[J]. J Clin Hepatol, 2025, 41( 7): 1270- 1274. DOI: 10.12449/JCH250707.

    郑林华, 韩英. 原发性胆汁性胆管炎个性化诊疗策略[J]. 临床肝胆病杂志, 2025, 41( 7): 1270- 1274. DOI: 10.12449/JCH250707.
    [18]
    LI B, ZHANG J, CHEN Y, et al. Alterations in microbiota and their metabolites are associated with beneficial effects of bile acid sequestrant on icteric primary biliary cholangitis[J]. Gut Microbes, 2021, 13( 1): 1946366. DOI: 10.1080/19490976.2021.1946366.
    [19]
    DAI Z, SONG GQ, BALAKRISHNAN A, et al. Growth differentiation factor 11 attenuates liver fibrosis via expansion of liver progenitor cells[J]. Gut, 2020, 69( 6): 1104- 1115. DOI: 10.1136/gutjnl-2019-318812.
    [20]
    CAO WL, LI M, LIU JY, et al. LGR5 marks targetable tumor-initiating cells in mouse liver cancer[J]. Nat Commun, 2020, 11( 1): 1961. DOI: 10.1038/s41467-020-15846-0.
    [21]
    CAROLINA E, KUSE Y, OKUMURA A, et al. Generation of human iPSC-derived 3D bile duct within liver organoid by incorporating human iPSC-derived blood vessel[J]. Nat Commun, 2024, 15( 1): 7424. DOI: 10.1038/s41467-024-51487-3.
    [22]
    OGAWA M, JIANG JX, XIA S, et al. Generation of functional ciliated cholangiocytes from human pluripotent stem cells[J]. Nat Commun, 2021, 12( 1): 6504. DOI: 10.1038/s41467-021-26764-0.
    [23]
    CHEN L, ELIZALDE M, DUBOIS LJ, et al. GAL3ST1 deficiency reduces epithelial-mesenchymal transition and tumorigenic capacity in a cholangiocarcinoma cell line[J]. Int J Mol Sci, 2024, 25( 13): 7279. DOI: 10.3390/ijms25137279.
    [24]
    CHAIYADET S, TANGKAWATTANA S, SMOUT MJ, et al. Knockout of liver fluke granulin, Ov-grn-1, impedes malignant transformation during chronic infection with Opisthorchis viverrini[J]. PLoS Pathog, 2022, 18( 9): e1010839. DOI: 10.1371/journal.ppat.1010839.
    [25]
    PICARD FSR, LUTZ V, BRICHKINA A, et al. IL-17A-producing CD8+ T cells promote PDAC via induction of inflammatory cancer-associated fibroblasts[J]. Gut, 2023, 72( 8): 1510- 1522. DOI: 10.1136/gutjnl-2022-327855.
    [26]
    Society of Microecology, Chinese Preventive Medical Association. Evidence-based guideline for pediatric clinical application of probiotics(2023)[J]. Chin J Pract Pediatr, 2024, 39( 1): 1- 15, 20. DOI: 10.19538/j.ek2024010601.

    中华预防医学会微生态学分会. 益生菌儿科临床应用循证指南(2023)[J]. 中国实用儿科杂志, 2024, 39( 1): 1- 15, 20. DOI: 10.19538/j.ek2024010601.
    [27]
    LIU YH, CHEN KF, LI FY, et al. Probiotic Lactobacillus rhamnosus GG prevents liver fibrosis through inhibiting hepatic bile acid synthesis and enhancing bile acid excretion in mice[J]. Hepatology, 2020, 71( 6): 2050- 2066. DOI: 10.1002/hep.30975.
    [28]
    MOON SH. Advances in IgG4-related hepatobiliary disease[J]. Korean J Pancreas Biliary Tract, 2020, 25( 2): 100- 106. DOI: 10.15279/kpba.2020.25.2.100.
    [29]
    LIU XL, PAN Q, CAO HX, et al. Lipotoxic hepatocyte-derived exosomal microRNA 192-5p activates macrophages through rictor/Akt/forkhead box transcription factor O1 signaling in nonalcoholic fatty liver disease[J]. Hepatology, 2020, 72( 2): 454- 469. DOI: 10.1002/hep.31050.
    [30]
    BARRY-HAMILTON V, SPANGLER R, MARSHALL D, et al. Allosteric inhibition of lysyl oxidase-like-2 impedes the development of a pathologic microenvironment[J]. Nat Med, 2010, 16( 9): 1009- 1017. DOI: 10.1038/nm.2208.
    [31]
    LIU HY, YIN G, FRANCO LEONARDI B, et al. Reactive cholangiocyte-derived ORM2 drives a pathogenic modulation of the injured biliary niche through macrophage reprogramming[J]. Gut, 2025, 74( 10): e334425. DOI: 10.1136/gutjnl-2024-334425.
    [32]
    WU N, ZHOU TH, CARPINO G, et al. Prolonged administration of a secretin receptor antagonist inhibits biliary senescence and liver fibrosis in Mdr2-/- mice[J]. Hepatology, 2023, 77( 6): 1849- 1865. DOI: 10.1097/HEP.0000000000000310.
    [33]
    CHEN ZW, KANG FP, XIE CK, et al. A novel Trojan horse nanotherapy strategy targeting the cPKM-STMN1/TGFB1 axis for effective treatment of intrahepatic cholangiocarcinoma[J]. Adv Sci, 2023, 10( 32): 2303814. DOI: 10.1002/advs.202303814.
    [34]
    HU CL, WANG L. Advances in the treatment of liver injury based on mesenchymal stem cell-derived exosomes[J]. Stem Cell Res Ther, 2024, 15( 1): 474. DOI: 10.1186/s13287-024-04087-3.
    [35]
    KIM Y, KANG K, LEE SB, et al. Small molecule-mediated reprogramming of human hepatocytes into bipotent progenitor cells[J]. J Hepatol, 2019, 70( 1): 97- 107. DOI: 10.1016/j.jhep.2018.09.007.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(1)

    Article Metrics

    Article views (25) PDF downloads(10) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return