Primary biliary cirrhosis. Is (and how much of) the pathology preventible?
Primary biliary cirrhosis (PBC) is a chronic, progressive cholestatic liver disease, which is invariably fatal. Circumstantial and indirect evidence suggests that autoimmune mechanisms have a role in the pathogenesis of PBC. Antimitochondrial antibodies (AMA) are highly sensitive and specific markers that can predict the development of the disease in a healthy individual. Long-term administration of ursodeoxycholic acid (UDCA), a naturally occurring bile acid, safely slows the progression of PBC, delays the need for liver transplantation, and postpones death. An effort should be made to identify the patients with PBC in the asymptomatic stage by the presence of AMA and to conduct a clinical trial in order to assess the benefit of long-term administration of UDCA on the prevention of the overt disease in these individuals.
Bar-Dayan
Y
Y
Department of Medicine B, Chaim Sheba Medical Center, Tel Hashomer Hospital, Tel-Aviv, Israel.
Gershwin
M E
ME
Levi
Y
Y
Amital
H
H
Shoenfeld
Y
Y
D000906:Antibodies / Q000032:analysis; D000918:Antibody Specificity; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control*; D015415:Biomarkers; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control*; D008928:Mitochondria / Q000276:immunology; D012307:Risk Factors; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D000906:Antibodies; D015415:Biomarkers; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid