title: Therapeutic role of bile acids and nuclear receptor agonists in fibrosing cholangiopathies.
abstract: Chronic inflammatory bile duct diseases such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) result in progressive fibrosis of the biliary tract and ultimately cirrhosis of the liver. Since the etiology and pathogenesis of these fibrosing cholangiopathies are still poorly understood, therapeutic options are rather limited at present. Ursodeoxycholic acid (UDCA) is the paradigm therapeutic bile acid and established standard treatment for PBC, but its role for medical therapy of PSC is still under debate. Promising novel bile acid-based therapeutic options include 24-norursodeoxycholic acid, a side chain-shortened C23 homologue of UDCA, and bile acid receptor/farnesoid X receptor agonists (e.g., obeticholic acid) which currently undergo clinical development for fibrosing cholangiopathies such as PBC and PSC. Other nuclear receptors such as vitamin D receptor and fatty acid-activated peroxisome proliferator-activated receptors are also of considerable interest. This review article is a summary of an overview talk given at Falk Symposium 191 on Advances in Pathogenesis and Treatment of Liver Diseases held in London, October 3-4, 2013, and summarizes the recent progress with novel therapeutic bile acids and bile acid derivatives as novel therapies for fibrosing cholangiopathies such as PBC and PSC.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.forename: Emina
authors.initials: E
authors.lastname: Halilbasic
authors.forename: Lili
authors.initials: L
authors.lastname: Kazemi-Shirazi
authors.forename: Christian
authors.initials: C
authors.lastname: Kienbacher
authors.forename: Katharina
authors.initials: K
authors.lastname: Staufer
authors.forename: Stefan
authors.initials: S
authors.lastname: Traussnigg
authors.forename: Harald
authors.initials: H
authors.lastname: Hofer
mesh_terms: D001647:Bile Acids and Salts / Q000627:therapeutic use*; D015209:Cholangitis, Sclerosing / Q000188:drug therapy*; D006801:Humans; D008024:Ligands; D018160:Receptors, Cytoplasmic and Nuclear / Q000819:agonists* / Q000378:metabolism; D014580:Ursodeoxycholic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D001647:Bile Acids and Salts; D008024:Ligands; D018160:Receptors, Cytoplasmic and Nuclear; D014580:Ursodeoxycholic Acid; C081331:24-norursodeoxycholic acid