Intrahepatic cholestasis in common chronic liver diseases

Jüngst, Christoph; Berg, Thomas; Cheng, Jun; Green, Richard M.; Jia, Jidong; Mason, Andrew L.; Lammert, Frank

doi:10.1111/eci.12128

Cited by 58 publications

(47 citation statements)

References 123 publications

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“…Representative aspects of architectural changes and sinusoidal inflammation observed in a PAD patient (patient number 2) are shown in Figure 3. In blood chemistry, mainly signs of cholestasis were found, common in liver diseases [21]. All 5 patients (100%) who fulfilled the criteria for INCPH had abnormalities in liver enzymes: 4 had signs of cholestasis and 1 showed an increase of transaminase levels (Supplementary Table 1).…”

Section: Resultsmentioning

confidence: 99%

Idiopathic Non Cirrhotic Portal Hypertension and Spleno-Portal Axis Abnormalities in Patients with Severe Primary Antibody Deficiencies

Pulvirenti

Pentassuglio

Milito

et al. 2014

Journal of Immunology Research

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Background and Aim. Portal hypertension has been reported in association with acquired and primary immune deficiencies without a comprehensive description of associated spleno-portal axis abnormalities. Pathological mechanisms are poorly defined. Methods. Observational, single centre study with the aim of assessing the prevalence of spleno-portal axis abnormalities in an unselected cohort of 123 patients with primary antibody deficiencies and without known causes of liver diseases regularly followed up for a mean time of 18 ± 14 years. A cumulative period of 1867 patients-year was analysed. Clinical and immunological data, abdominal ultrasounds, CT scans, and endoscopy features were included in the analysis. Results. Twenty-five percent of patients with primary antibody deficiencies had signs of portal vein enlargement but only 4% of them had portal hypertension, with portal systemic collaterals. Liver biopsies showed liver sinusoids congestive dilatation, endothelization, and micronodularity fulfilling the criteria for noncirrhotic portal hypertension. Patients with portal vein enlargement had severe clinical and immunological phenotypes. Conclusions. In primary antibody deficient patients, infections, inflammations, splenomegaly, increased blood venous flow, and lymphocyte abnormalities contribute to establishment of liver damage possibly leading to noncirrhotic portal hypertension. Patients with primary antibody deficiency should be considered a good model to give insight into the pathological mechanisms underlying noncirrhotic portal hypertension.

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Section: Resultsmentioning

confidence: 99%

Idiopathic Non Cirrhotic Portal Hypertension and Spleno-Portal Axis Abnormalities in Patients with Severe Primary Antibody Deficiencies

Pulvirenti

Pentassuglio

Milito

et al. 2014

Journal of Immunology Research

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“…31 It has been reported that there is limited correlation between the biochemical categorization and the pathological pattern of injury. 32 For example, an injury that would be classified as cholestatic on biochemical grounds could show acute or chronic hepatitis without evidence of bile accumulation.…”

Section: Drug-induced Liver Injurymentioning

confidence: 99%

Pathophysiology and Diseases of the Proximal Pathways of the Biliary System

Nakanishi¹,

Saxena

2015

Archives of Pathology &Amp; Laboratory Medicine

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Care of the patient with cholestasis hinges on identifying the etiology. Diagnostic steps in cholestatic conditions comprise a thorough patient history, abdominal imaging, distinct serological studies, and liver biopsy. Primary biliary cirrhosis is characterized by distinctive serological and histological findings. The small-duct variant of primary sclerosing cholangitis is very rare and difficult to diagnose; imaging of the bile ducts is not helpful. Graft-versus-host disease is characterized by damage and loss of intrahepatic bile ducts. Drugs can cause injury variably at the level of bile canaliculus or the interlobular bile duct. Loss of bile ducts may be seen with primary biliary cirrhosis, primary sclerosing cholangitis, graft-versus-host disease, and drug-induced liver injury. Progressive familial intrahepatic cholestasis and progressive familial intrahepatic cholestasis represent 2 extreme ends of the spectrum of abnormalities in transporters responsible for bile formation. Intrahepatic cholestasis of pregnancy has a variable incidence in different parts of the world and may be due to abnormalities in transporter molecules.

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“…Alcohol leads to an increase in BA biosynthesis in both humans and mice . Of note, clinically, as in other chronic liver diseases, mild cholestasis is common in patients with ALD . BAs activate FXR in the ileum; impaired FXR activation has been associated with more alcohol‐induced liver injury .…”

Section: Introductionmentioning

confidence: 99%

Gut microbiota in non‐alcoholic fatty liver disease and alcohol‐related liver disease: Current concepts and perspectives

Arab

Arrese

Shah

2020

Hepatology Research

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The term, gut-liver axis, is used to highlight the close anatomical and functional relationship between the intestine and the liver. It has been increasingly recognized that the gut-liver axis plays an essential role in the development and progression of liver disease. In particular, in non-alcoholic fatty liver disease and alcohol-related liver disease, the two most common causes of chronic liver disease, a dysbiotic gut microbiota can influence intestinal permeability, allowing some pathogens or bacteriaderived factors from the gut reaching the liver through the enterohepatic circulation contributing to liver injury, steatohepatitis, and fibrosis progression. Pathways involved are multiple, including changes in bile acid metabolism, intestinal ethanol production, generation of short-chain fatty acids, and other by-products. Bile acids act through dedicated bile acid receptors, farnesoid X receptor and TGR5, in both the ileum and the liver, influencing lipid metabolism, inflammation, and fibrogenesis. Currently, both non-alcoholic fatty liver disease and alcohol-related liver disease lack effective therapies, and therapeutic targeting of gut microbiota and bile acids enterohepatic circulation holds promise. In this review, we summarize current knowledge about the role of gut microbiota in the pathogenesis of non-alcoholic fatty liver disease and alcohol-related liver disease, as well as the relevance of microbiota or bile acid-based approaches in the management of those liver diseases.

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Intrahepatic cholestasis in common chronic liver diseases

Cited by 58 publications

References 123 publications

Idiopathic Non Cirrhotic Portal Hypertension and Spleno-Portal Axis Abnormalities in Patients with Severe Primary Antibody Deficiencies

Idiopathic Non Cirrhotic Portal Hypertension and Spleno-Portal Axis Abnormalities in Patients with Severe Primary Antibody Deficiencies

Pathophysiology and Diseases of the Proximal Pathways of the Biliary System

Gut microbiota in non‐alcoholic fatty liver disease and alcohol‐related liver disease: Current concepts and perspectives

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