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

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