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

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.

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