title: Estrogens and the pathophysiology of the biliary tree.
abstract: The scientific framework concerning estrogen effects on different tissues has expanded enormously during the last decades, when estrogen receptor (ER) subtypes were identified. Estrogens are not only essential for the female reproductive system, but they also control fundamental functions in other tissues including the cardiovascular system, bone, brain and liver. Recently, estrogens have been shown to target the biliary tree, where they modulate the proliferative and secretory activities of cholangiocytes, the epithelial cells lining bile ducts. By acting on both estrogen receptors (ER-alpha) and (ER-beta) subtypes, and by activating either genomic or non-genomic pathways, estrogens play a key role in the complex loop of growth factors and cytokines, which modulates the proliferative response of cholangiocytes to damage. Specifically, estrogens activate intracellular signalling cascades [ERK(1/2) (extracellular regulated kinases (1/2), PI3- kinase/AKT (phosphatidylinositol-3' kinase/AKT)] typical of growth factors such as insulin like growth factor (IGF1), nerve growth factor (NGF) and vascular endothelial growth factor (VEGF), thus potentiating their action. In addition, estrogens stimulate the secretion of different growth factors in proliferating cholangiocytes. This review specifically deals with the recent advances related to the role and mechanisms by which estrogens modulate cholangiocyte functions in normal and pathological conditions.
authors.affiliation: Division of Gastroenterology, University of Rome, La Sapienza, via R. Rossellini 51, 00137 Rome, Italy. domenico.alvaro@uniroma1.it
authors.forename: Domenico
authors.initials: D
authors.lastname: Alvaro
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Mancino
authors.forename: Paolo
authors.initials: P
authors.lastname: Onori
authors.forename: Antonio
authors.initials: A
authors.lastname: Franchitto
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Alpini
authors.forename: Heather
authors.initials: H
authors.lastname: Francis
authors.forename: Shannon
authors.initials: S
authors.lastname: Glaser
authors.forename: Eugenio
authors.initials: E
authors.lastname: Gaudio
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000502:physiology; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000503:physiopathology; D001653:Bile Ducts, Intrahepatic / Q000166:cytology* / Q000503:physiopathology; D001659:Biliary Tract / Q000473:pathology* / Q000503:physiopathology*; D049109:Cell Proliferation; D018281:Cholangiocarcinoma / Q000473:pathology / Q000503:physiopathology; D016207:Cytokines / Q000502:physiology; D042783:Endothelial Cells / Q000187:drug effects / Q000502:physiology; D004967:Estrogens / Q000502:physiology*; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000473:pathology / Q000503:physiopathology; D016891:Polycystic Kidney, Autosomal Dominant / Q000473:pathology / Q000503:physiopathology; D011960:Receptors, Estrogen / Q000502:physiology*; D015398:Signal Transduction / Q000502:physiology
chemical_list: D016207:Cytokines; D004967:Estrogens; D006133:Growth Substances; D011960:Receptors, Estrogen