Why Doesn’t Primary Biliary Cholangitis Respond to Immunosuppressive Medications?

Abstract

Purpose of Review: The purpose of this review is to discuss reasons why immunosuppressive therapy so far failed in Primary Biliry Cholangitis. Recent Findings: Even targeted immunosuppressive therapy seems ineffective or potentially harmful. Summary: Bile acid-mediated cholangiocyte damage, facilitated by insufficient bicarbonate secretion, seems to attenuate the anti-inflammatory and anti-fibrotic actions of immunosuppressant and immunomodulatory drugs in a clinically significant way.