Pathogenesis and medical therapy of primary sclerosing cholangitis. Any news?

Primary sclerosing cholangitis is characterized by inflammation and fibrosis of the intra- and extrahepatic bile ducts. Medical therapy has focused on anticholestatic, antiinflammatory and immunosuppressive drugs. Although inflammation, fibrosis and cholestasis may all occur at the same time, inflammation dominates the early phase and fibrosis and cholestasis the later stages. With inflammatory bowel disease and rheumatoid arthritis as stimulants, research on anti-inflammatory drugs is in a very active stage, with an emphasis on cytokines and cytokine antagonists. For patients with primary sclerosing cholestasis to fully benefit from these developments, it is necessary to define the early disease stage that constitutes a potential therapeutic window for these agents. (C) 1999 Lippincott Williams & Wilkins.