Ursodeoxycholic acid for the treatment of primary sclerosing cholangitis

摘要

Ursodeoxycholic acid (UDCA) is widely used on an empirical basis for the treatment of primary sclerosing cholangitis (PSC) and is currently being tested in clinical trials. UDCA has multiple effects which may be operative in patients with cholestatic liver disease such as PSC. The possible beneficial effects include: alteration of the bile acid pool to be less cytotoxic, direct reduction of cytotoxicity, amelioration of apoptosis, reduction in HLA antigen displayed by potential target cells, and a reduction in production of various cytokines. It is unclear whether UDCA is beneficial for a long-term clinical outcome for patients with PSC, although it clearly improves liver biochemistries and in small studies has improved histology and cholangiograms. It may reduce the risk of colon cancer in patients with complicating ulcerative colitis.