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[Intrahepatic cholangitis with presumably immunologic bases]

O Klinge1

  • 1Institut für Pathologie, Städtische Kliniken Kassel.

Verhandlungen Der Deutschen Gesellschaft Fur Pathologie
|January 1, 1995
PubMed
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This overview discusses chronic cholangitides, including primary biliary cirrhosis and primary sclerosing cholangitis. Future research needs to clarify immunocholangitis, though immunohistochemistry suggests immune involvement in pathogenesis.

Area of Science:

  • Gastroenterology and Hepatology
  • Immunology
  • Pathology

Background:

  • Chronic cholangitides encompass several conditions, including primary biliary cirrhosis (PBC), immunocholangitis, and primary sclerosing cholangitis (PSC).
  • These conditions can progress to PBC over extended periods.
  • Histological patterns are established for PBC and PSC, but immunocholangitis requires further definition.

Purpose of the Study:

  • To provide an overview of three types of chronic cholangitides.
  • To highlight the current understanding and future research needs for immunocholangitis.
  • To discuss the pathogenesis and histological features of these biliary diseases.

Main Methods:

  • Review of existing literature on chronic cholangitides.
  • Analysis of histological patterns in defined conditions.

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  • Examination of immunohistochemical, electron microscopic, and histochemical studies.

    • Main Results:

    • Histological patterns are well-defined for chronic non-destructive cholangitis (PBC) and PSC.
    • Immunocholangitis requires further clinical, laboratory, and histological evaluation.
    • Immunohistochemical studies provide evidence for immune-related pathogenesis.
    • Vascular lesions and basement membrane changes appear to have minor roles in bile duct destruction and fibrosis.
    • Ductal neoformation results from hepatocellular metaplasia, preceding fibrosis.

    Conclusions:

    • Chronic cholangitides share potential pathways, with PBC as a common endpoint.
    • Immunocholangitis pathogenesis needs more precise elucidation, despite evidence of immune involvement.
    • Hepatocellular metaplasia plays a key role in ductal regeneration and subsequent fibrosis in sclerosing cholangitis.