中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 7
Jul.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(7): 1241-1245

Precision diagnosis and treatment of cholestatic liver disease and frontier exploration

DOI: 10.12449/JCH250701

  • Department of Gastroenterology，The First Affiliated Hospital of Army Medical University （Third Military Medical University），Cholestatic Liver Diseases Center，Metabolic Dysfunction-Associated Steatotic Liver Disease Medical Research Center，Chongqing 400038，China

Research funding:

National Natural Science Foundation of China for Outstanding Young Scholars (82325008);

Original Exploration Program of the National Science Foundation of China (82450104)

More Information
  • Corresponding author: CHAI Jin， jin.chai@cldcsw.org （ORCID： 0000-0002-8543-4566）
  • Received Date: 2025-04-19
  • Accepted Date: 2025-05-31
  • Published Date: 2025-07-25
    Abstract
  • Cholestatic liver disease （CLD） encompasses a range of acute and chronic disorders characterized by impaired bile formation and/or flow. If left untreated， it may progress to cirrhosis and even liver failure. In recent years， with the development of molecular biology and omics technologies， the diagnosis and treatment of CLD are entering the era of precision medicine. This article reviews the advances in the diagnosis of CLD based on genetic testing and omics biomarkers and summarizes the latest studies and clinical trials on hydrophilic bile acid， FXR agonist， PPAR agonist， antibiotics， and novel molecules in targeted therapy for CLD. In the future， integrating omics data and implementing individualized diagnosis and treatment will be the main directions in precision medicine for CLD. This article aims to provide a reference for basic research and clinical translation in the field of CLD.

     

    • FullText(HTML)
  • loading
    • References(28)
  • [1]
    European Association for the Study of the Liver. EASL clinical practice guidelines: Management of cholestatic liver diseases[J]. J Hepatol, 2009, 51( 2): 237- 267. DOI: 10.1016/j.jhep.2009.04.009.
    [2]
    POLLOCK G, MINUK GY. Diagnostic considerations for cholestatic liver disease[J]. J Gastroenterol Hepatol, 2017, 32( 7): 1303- 1309. DOI: 10.1111/jgh.13738.
    [3]
    PIETERS A, GIJBELS E, COGLIATI B, et al. Biomarkers of cholestasis[J]. Biomark Med, 2021, 15( 6): 437- 454. DOI: 10.2217/bmm-2020-0691.
    [4]
    CAO XX, GAO YQ, ZHANG WH, et al. Cholestasis morbidity rate in first-hospitalized patients with chronic liver disease in Shanghai[J]. Chin J Hepatol, 2015, 23( 8): 569- 573. DOI: 10.3760/cma.j.issn.1007-3418.2015.08.003.

    曹旬旬, 高月求, 张文宏, 等. 基于上海市住院慢性肝病患者胆汁淤积患病率的调查研究[J]. 中华肝脏病杂志, 2015, 23( 8): 569- 573. DOI: 10.3760/cma.j.issn.1007-3418.2015.08.003.
    [5]
    BORTOLINI M, ALMASIO P, BRAY G, et al. Multicentre survey of the prevalence of intrahepatic cholestasis in 2520 consecutive patients with newly diagnosed chronic liver disease[J]. Drug Invest, 1992, 4( Suppl 4): 83- 89. DOI: 10.1007/BF03258368.
    [6]
    Chinese Society of Hepatology, Chinese Medical Association. Guideline on the management of cholestasis liver diseases(2021)[J]. J Clin Hepatol, 2022, 38( 1): 62- 69. DOI: 10.3760/cma.j.cn112138-20211112-00795.

    中华医学会肝病学分会. 胆汁淤积性肝病管理指南(2021年)[J]. 临床肝胆病杂志, 2022, 38( 1): 62- 69. DOI: 10.3760/cma.j.cn112138-20211112-00795.
    [7]
    LLEO A, JEPSEN P, MORENGHI E, et al. Evolving trends in female to male incidence and male mortality of primary biliary cholangitis[J]. Sci Rep, 2016, 6: 25906. DOI: 10.1038/srep25906.
    [8]
    LU M, ZHOU YR, HALLER IV, et al. Increasing prevalence of primary biliary cholangitis and reduced mortality with treatment[J]. Clin Gastroenterol Hepatol, 2018, 16( 8): 1342- 1350. e 1. DOI: 10.1016/j.cgh.2017.12.033.
    [9]
    LV TT, CHEN S, LI M, et al. Regional variation and temporal trend of primary biliary cholangitis epidemiology: A systematic review and meta-analysis[J]. J Gastroenterol Hepatol, 2021, 36( 6): 1423- 1434. DOI: 10.1111/jgh.15329.
    [10]
    ZENG N, DUAN WJ, CHEN S, et al. Epidemiology and clinical course of primary biliary cholangitis in the Asia-Pacific region: A systematic review and meta-analysis[J]. Hepatol Int, 2019, 13( 6): 788- 799. DOI: 10.1007/s12072-019-09984-x.
    [11]
    LINDOR KD, KOWDLEY KV, HARRISON ME, et al. ACG clinical guideline: Primary sclerosing cholangitis[J]. Am J Gastroenterol, 2015, 110( 5): 646- 659; quiz660. DOI: 10.1038/ajg.2015.112.
    [12]
    JOO M, ABREU-E-LIMA P, FARRAYE F, et al. Pathologic features of ulcerative colitis in patients with primary sclerosing cholangitis: A case-control study[J]. Am J Surg Pathol, 2009, 33( 6): 854- 862. DOI: 10.1097/PAS.0b013e318196d018.
    [13]
    TANAKA A, MA X, TAKAHASHI A, et al. Primary biliary cholangitis[J]. Lancet, 2024, 404( 10457): 1053- 1066. DOI: 10.1016/S0140-6736(24)01303-5.
    [14]
    LI X, LI Y, XIAO JT, et al. Unique DUOX2+ACE2+ small cholangiocytes are pathogenic targets for primary biliary cholangitis[J]. Nat Commun, 2023, 14( 1): 29. DOI: 10.1038/s41467-022-34606-w.
    [15]
    TRZOS K, PYDYN N, JURA J, et al. Selected transgenic murine models of human autoimmune liver diseases[J]. Pharmacol Rep, 2022, 74( 2): 263- 272. DOI: 10.1007/s43440-021-00351-y.
    [16]
    DURAZZO M, FERRO A, NAVARRO-TABLEROS VM, et al. Current treatment regimens and promising molecular therapies for chronic hepatobiliary diseases[J]. Biomolecules, 2025, 15( 1): 121. DOI: 10.3390/biom15010121.
    [17]
    LANKISCH TO, METZGER J, NEGM AA, et al. Bile proteomic profiles differentiate cholangiocarcinoma from primary sclerosing cholangitis and choledocholithiasis[J]. Hepatology, 2011, 53( 3): 875- 884. DOI: 10.1002/hep.24103.
    [18]
    VARGA T, CZIMMERER Z, NAGY L. PPARs are a unique set of fatty acid regulated transcription factors controlling both lipid metabolism and inflammation[J]. Biochim Biophys Acta, 2011, 1812( 8): 1007- 1022. DOI: 10.1016/j.bbadis.2011.02.014.
    [19]
    SCHRAMM C, WEDEMEYER H, MASON A, et al. Farnesoid X receptor agonist tropifexor attenuates cholestasis in a randomised trial in patients with primary biliary cholangitis[J]. JHEP Rep, 2022, 4( 11): 100544. DOI: 10.1016/j.jhepr.2022.100544.
    [20]
    YOU H, MA X, EFE C, et al. APASL clinical practice guidance: The diagnosis and management of patients with primary biliary cholangitis[J]. Hepatol Int, 2022, 16( 1): 1- 23. DOI: 10.1007/s12072-021-10276-6.
    [21]
    BOWLUS CL, GALAMBOS MR, ASPINALL RJ, et al. A phase II, randomized, open-label, 52-week study of seladelpar in patients with primary biliary cholangitis[J]. J Hepatol, 2022, 77( 2): 353- 364. DOI: 10.1016/j.jhep.2022.02.033.
    [22]
    SCHATTENBERG JM, PARES A, KOWDLEY KV, et al. A randomized placebo-controlled trial of elafibranor in patients with primary biliary cholangitis and incomplete response to UDCA[J]. J Hepatol, 2021, 74( 6): 1344- 1354. DOI: 10.1016/j.jhep.2021.01.013.
    [23]
    VUPPALANCHI R, CALDWELL SH, PYRSOPOULOS N, et al. Proof-of-concept study to evaluate the safety and efficacy of saroglitazar in patients with primary biliary cholangitis[J]. J Hepatol, 2022, 76( 1): 75- 85. DOI: 10.1016/j.jhep.2021.08.025.
    [24]
    ZHANG YL, LI ZJ, GOU HZ, et al. The gut microbiota-bile acid axis: A potential therapeutic target for liver fibrosis[J]. Front Cell Infect Microbiol, 2022, 12: 945368. DOI: 10.3389/fcimb.2022.945368.
    [25]
    ALLEGRETTI JR, KASSAM Z, CARRELLAS M, et al. Fecal microbiota transplantation in patients with primary sclerosing cholangitis: A pilot clinical trial[J]. Am J Gastroenterol, 2019, 114( 7): 1071- 1079. DOI: 10.14309/ajg.0000000000000115.
    [26]
    MAYO MJ, WIGG AJ, LEGGETT BA, et al. NGM282 for treatment of patients with primary biliary cholangitis: A multicenter, randomized, double-blind, placebo-controlled trial[J]. Hepatol Commun, 2018, 2( 9): 1037- 1050. DOI: 10.1002/hep4.1209.
    [27]
    van der WOERD WL, HOUWEN RH, van de GRAAF SF. Current and future therapies for inherited cholestatic liver diseases[J]. World J Gastroenterol, 2017, 23( 5): 763- 775. DOI: 10.3748/wjg.v23.i5.763.
    [28]
    ZHANG LJ, PAN Q, ZHANG L, et al. Runt-related transcription factor-1 ameliorates bile acid-induced hepatic inflammation in cholestasis through JAK/STAT3 signaling[J]. Hepatology, 2023, 77( 6): 1866- 1881. DOI: 10.1097/HEP.0000000000000041.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (603) PDF downloads(264) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return