目前用于治疗原发性硬化胆管炎的治疗方法
Natassia Tan1, John Lubel1, William Kemp1
1Department of Gastroenterology and Hepatology, Alfred Health; Central Clinical School, Monash University, Melbourne, Australia.
Journal of clinical and translational hepatology
|August 14, 2023
概括
原发性硬化性脑膜炎 (PSC) 是一种罕见的肝病,没有治愈方法. 新兴疗法针对肠道健康,胆酸和癌症风险,为患者提供了新的希望.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 原发性硬化性脑膜炎 (PSC) 是一种孤儿胆固醇性肝病,其特征是炎症性胆道狭窄.
- 病理生理学涉及免疫失调,肠道失调,环境因素,肠肝交叉,以及改变的胆酸代谢.
- 目前的治疗方法在改变疾病进展方面缺乏有效性,肝移植是最终阶段疾病的唯一选择.
研究的目的:
- 审查目前对原发性硬化胆管炎 (PSC) 的理解和新兴治疗策略.
- 突出潜在的治疗方法,解决PSC的潜在病理生理学.
- 讨论PSC患者并发症和相关风险的管理选择.
主要方法:
- 对PSC病理生理学和治疗现有文献的综述.
- 分析当前和试验性治疗方法,包括微生物组操纵,胆酸调制和药理干预措施.
- 评估管理PSC并发症和相关恶性瘤的策略.
主要成果:
- 乌尔索西胆酸的疗效有限,改善了肝脏的生物化学,但没有改善生存结果.
- 便微生物群移植和抗生素对肠道微生物群的操纵有希望.
- 合成胆汁酸,核受体激动剂,纤维酸,他类药物和阿司匹林在临床试验中显示出潜力.
结论:
- 目前没有经过验证的药物治疗可以改变PSC疾病的进展.
- 针对肠道微生物群,胆酸代谢和减少癌症风险的新兴疗法显示出显著的希望.
- 在PSC的症状性收缩管理中,内镜气球扩张是优先选择的,而不是支架.
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