New insights into the pathogenesis of primary biliary cholangitis asymptomatic stage  

作　　者：Vasiliy Ivanovich Reshetnyak Igor Veniaminovich Maev 

机构地区：[1]Department of Propaedeutics of Internal Diseases and Gastroenterology,A.I.Yevdokimov Moscow State University of Medicine and Dentistry,Moscow 127473,Russia

出　　处：《World Journal of Gastroenterology》2023年第37期5292-5304,共13页世界胃肠病学杂志（英文版）

摘　　要：Primary biliary cholangitis(PBC)is a chronic cholestatic progressive liver disease and one of the most important progressive cholangiopathies in adults.Damage to cholangiocytes triggers the development of intrahepatic cholestasis,which progresses to cirrhosis in the terminal stage of the disease.Accumulating data indicate that damage to biliary epithelial cells[(BECs),cholangiocytes]is most likely associated with the intracellular accumulation of bile acids,which have potent detergent properties and damaging effects on cell membranes.The mechanisms underlying uncontrolled bile acid intake into BECs in PBC are associated with pH change in the bile duct lumen,which is controlled by the bicarbonate(HCO3-)buffer system“biliary HCO3-umbrella”.The impaired production and entry of HCO3-from BECs into the bile duct lumen is due to epigenetic changes in expression of the X-linked microRNA 506.Based on the growing body of knowledge on the molecular mechanisms of cholangiocyte damage in patients with PBC,we propose a hypothesis explaining the pathogenesis of the first morphologic(ductulopenia),immunologic(antimitochondrial autoantibodies)and clinical(weakness,malaise,rapid fatigue)signs of the disease in the asymptomatic stage.This review focuses on the consideration of these mechanisms.

关 键 词：Primary biliary cholangitis Antimitochondrial autoantibodies MicroRNA 506 Inositol-1 4 5-trisphosphate receptor type 3 Chloride/bicarbonate anion exchanger 2 Biliary bicarbonate umbrella Dihydrolipoyl transacetylase(E2 subunit) Pyruvate dehydrogenase complex 

分 类 号：R575.7[医药卫生—消化系统]