Bile acid therapy and markers of immune-mediated damage in primary biliary cirrhosis.
In primary biliary cirrhosis (PBC), liver damage results from both immune- and bile acid-mediated mechanisms. Therapies directed against the former have been either ineffective or toxic, while bile salt therapy is well tolerated but of uncertain long-term benefit. Because of slow disease progression, there is a need for surrogate markers of long-term efficacy. Candidates include markers of immune activation, such as soluble intercellular adhesion molecule-1 (sICAM-1) which shows promise in this respect. Using this marker, evidence has been presented to suggest an additive effect of the combination of ursodeoxycholic acid (UDCA) with azathioprine and prednisone in a short-term trial in PBC.
de Caestecker
J S
JS
Glenfield Hospital, Leicester, UK.
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis*; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy* / Q000276:immunology* / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D002756:Cholagogues and Choleretics; D007166:Immunosuppressive Agents; D018799:Intercellular Adhesion Molecule-1; D014580:Ursodeoxycholic Acid; D001379:Azathioprine; D011241:Prednisone