Toward precision medicine in primary biliary cholangitis.
Primary biliary cholangitis is a chronic, cholestatic liver disease characterized by a heterogeneous presentation, symptomatology, disease progression and response to therapy. In contrast, clinical management and treatment of PBC is homogeneous with a 'one size fits all' approach. The evolving research landscape, with the emergence of the -omics field and the availability of large patient cohorts are creating a unique opportunity of translational epidemiology. Furthermore, several novel disease and symptom-modifying agents for PBC are currently in development. The time is therefore ripe for precision medicine in PBC. In this manuscript we describe the concept of precision medicine; review current approaches to risk-stratification in PBC, and speculate how precision medicine in PBC might develop in the near future.
Academic Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom; MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom; Liver Unit, Humanitas Clinical and Research Institute, Rozzano (Milan), Italy.
Marco
M
Carbone
Liver Unit, Humanitas Clinical and Research Institute, Rozzano (Milan), Italy.
Vincenzo
V
Ronca
Liver Unit, Humanitas Clinical and Research Institute, Rozzano (Milan), Italy.
Savino
S
Bruno
Program for Autoimmune Liver Diseases, International Center for Digestive Health, Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
Pietro
P
Invernizzi
Academic Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom; MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
George F
GF
Mells
D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D002761:Cholangitis / Q000175:diagnosis / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000188:drug therapy*; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology; D057285:Precision Medicine / Q000639:trends*; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid
Precision medicine; Primary biliary cholangitis; Risk-stratification