2012
DOI: 10.1159/000341123
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Primary Sclerosing Cholangitis: New Approaches to Diagnosis, Surveillance and Treatment

Abstract: Primary sclerosing cholangitis (PSC) is a chronic inflammatory bile duct disease of unknown etiology, frequently associated with inflammatory bowel disease and leading to end-stage liver disease requiring liver transplantation. Moreover, PSC is a premalignant condition associated with an increased risk for hepatobiliary and colorectal malignancy. Since effective medical therapy for PSC is still lacking, this disorder represents a potentially fatal disease with poor prognosis. This article is a summary of an ov… Show more

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Cited by 18 publications
(15 citation statements)
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“…nor UDCA also counteracts lipotoxic fatty acid composition and promotes bile acid (BA) detoxification and elimination via alterative elimination pumps (Mrp3 and 4) back into plasma, later facilitating their renal excretion. Modified from [39]. …”
Section: Introductionmentioning
confidence: 99%
“…nor UDCA also counteracts lipotoxic fatty acid composition and promotes bile acid (BA) detoxification and elimination via alterative elimination pumps (Mrp3 and 4) back into plasma, later facilitating their renal excretion. Modified from [39]. …”
Section: Introductionmentioning
confidence: 99%
“…Current evidence indicates: (i) the role of UDCA in slowing PSC progression has not been demonstrated; (ii) conventional-dose UDCA is safe, but the efficacy is unclear; (iii) high-dose UDCA (28-30 mg/kg/day) in PSC may be even harmful [reviewed in [21]]. Moreover, there is limited information to support UDCA as a chemopreventive drug against colorectal or cholangiocellular cancer [21,22]. As such, the American Association for the Study of Liver Disease (AASLD) recommendations advise against the use of UDCA in PSC [10], while the European Association for the Study of the Liver (EASL) recommendations are open for its use (especially in early-stage disease) [9], while emphasizing that the limited data do not allow a specific recommendation for the general use of UDCA in PSC [reviewed in [21]].…”
Section: Limitations For Udca As Baseline Therapy In Fibrosing Cholanmentioning
confidence: 99%
“…As such, the American Association for the Study of Liver Disease (AASLD) recommendations advise against the use of UDCA in PSC [10], while the European Association for the Study of the Liver (EASL) recommendations are open for its use (especially in early-stage disease) [9], while emphasizing that the limited data do not allow a specific recommendation for the general use of UDCA in PSC [reviewed in [21]]. Of note, in daily clinical practice, UDCA is combined with endoscopic therapy of dominant strictures - an approach shown to improve predicted patient survival in retrospective trials [9,10,22,23]. Therefore, there is an urgent need for novel therapeutic approaches in cholangiopathies such as PSC [22].…”
Section: Limitations For Udca As Baseline Therapy In Fibrosing Cholanmentioning
confidence: 99%
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“…New proteomic analysis performed both in urine and bile samples might allow in the future to differentiate between benign and malignant strictures in PSC patients [13]. There is an urgent need for better therapies in this disorder, and new therapies are currently under investigation (table 1) [14]. …”
Section: Primary Sclerosing Cholangitismentioning
confidence: 99%