ArticleJHEP reports : innovation in hepatology2022
Role of ductular reaction and ductular-canalicular junctions in identifying severe primary biliary cholangitis.
Article in JHEP reports : innovation in hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 26 citations in OpenAlex.
- Clinicopathological features of hepatobiliary cells in primary biliary cholangitis patients with incomplete response to ursodeoxycholic acid.BMC gastroenterology · 2026Article
- Role of Gut-Derived Endotoxins in Porto-Sinusoidal Vascular Disorder: Comparison Between patients with and without portal hypertension.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Review
- Maternal Western Diet Programmes Bile Acid Dysregulation and Hepatic Fibrosis in Fetal and Juvenile Macaques.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Clinical outcomes and early- prognostic biomarkers of primary biliary cholangitis with ductopenia.Frontiers in immunology · 2025Article
- Unraveling the complexities of fibrosis and ductular reaction in liver disease: pathogenesis, mechanisms, and therapeutic insights.American journal of physiology. Cell physiology · 2024Review
- Gastroesophageal varices in primary biliary cholangitis with anti-centromere antibody positivity: Early onset?Open life sciences · 2024Article
- Sequence of events leading to primary biliary cholangitis.World journal of gastroenterology · 2023Review
- Panic at the Bile Duct: How Intrahepatic Cholangiocytes Respond to Stress and Injury.The American journal of pathology · 2023Review
- Reply to: "Ductular reaction is a prognostic factor in primary biliary cholangitis".JHEP reports : innovation in hepatology · 2023Article
- Ductular reaction is a prognostic factor in primary biliary cholangitis.JHEP reports : innovation in hepatology · 2023Article
- Reversine attenuates cholestatic ductular reaction in rats.FEBS open bio · 2023Article
- Consensus statements of the Hellenic Autoimmune Liver Diseases Study Group on the diagnosis and current management of primary biliary cholangitis.Annals of gastroenterologyArticle
Corrections and comments
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Authors and funding
20 authors at 9 institutions in 2 countries.
Funding
Abstract
Background & Aims: Primary biliary cholangitis (PBC) is a chronic cholangiopathy characterised by immuno-mediated injury of interlobular bile ducts leading to intrahepatic cholestasis and progressive liver fibrosis. PBC histology is characterised by portal inflammation, progressive fibrosis, ductopenia, and the appearance of the so-called ductular reaction. The aim of the present study was to investigate the pathogenetic relevance of ductular reaction in PBC. Methods: Liver biopsies were collected from naïve people with PBC (N = 87). Clinical-serological parameters were obtained at diagnosis and after 1 year of ursodeoxycholic acid (UDCA) treatment. Histological staging was performed on all slides according to multiple scoring systems and criteria for PBC. Liver samples were obtained from Results: Ductular reaction in people with PBC correlated with the disease stage and liver fibrosis, but not with disease activity; an extensive ductular reaction correlated with serum alkaline phosphatase levels at diagnosis, response to UDCA, and individuals' estimated survival, independently from other histological parameters, including disease stage. In people with PBC, reactive ductules were associated with the establishment of junctions with bile canaliculi and with fibrogenetic cell activation. Consistently, in a mouse model of intrahepatic cholestasis, UDCA treatment was effective in reducing ductular reaction and fibrosis and increasing ductular-canalicular junctions. Conclusions: Extensive ductular reaction outlines a severe histologic phenotype in PBC and is associated with an inadequate therapy response and a worse estimated prognosis. Lay summary: In people affected by primary biliary cholangitis (PBC), the histological appearance of extensive ductular reaction identifies individuals at risk of progressive fibrosis. Ductular reaction at diagnosis correlates with the lack of response to first-line therapy with ursodeoxycholic acid and serves to restore ductular-canalicular junctions in people with PBC. Assessing ductular reaction extension at diagnosis may add valuable information for clinicians.
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