The Role of Genetic and Immune Factors for the Pathogenesis of Primary Sclerosing Cholangitis in Childhood

• Published in: Gastroenterology research and practice Vol. 2016; no. 2016; pp. 1 - 8
• Main Authors: Ferreira, Alexandre Rodrigues, Fagundes, Eleonora Druve Tavares, Aquino, Diego Junior Queiroga de, Campos Silva, Soraya Luiza, Simões e Silva, Ana Cristina, Ferri, Priscila Menezes, Miranda, Débora Marques
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2016; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Antigens; Bile; Care and treatment; Cell adhesion & migration; Chemokines; Cholangitis; Development and progression; Genetic aspects; Genotype; Haplotypes; Health aspects; Immune response; Inflammatory bowel disease; Laboratories; Ligands; Liver diseases; Lymphocytes; Pathogenesis; Pediatrics; Recruitment; Review; Studies
• ISSN: 1687-6121; 1687-630X
• DOI: 10.1155/2016/3905240

Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease characterized by chronic inflammation of the biliary tree resulting in liver fibrosis. PSC is more common in male less than 40 years of age. The diagnosis of PSC is based on clinical, laboratory, image, and histological findings. A biochemical profile of mild to severe chronic cholestasis can be observed. Endoscopic retrograde cholangiography is the golden standard method for diagnosis, but magnetic resonance cholangiography is currently also considered a first-line method of investigation. Differences in clinical and laboratory findings were observed in young patients, including higher incidence of overlap syndromes, mostly with autoimmune hepatitis, higher serum levels of aminotransferases and gamma-glutamyl transferase, and lower incidence of serious complications as cholangiocarcinoma. In spite of the detection of several HLA variants as associated factors in large multicenter cohorts of adult patients, the exact role and pathways of these susceptibility genes remain to be determined in pediatric population. In addition, the literature supports a role for an altered immune response to pathogens in the pathogenesis of PSC. This phenomenon contributes to abnormal immune system activation and perpetuation of the inflammatory process. In this article, we review the role of immune and genetic factors in the pathogenesis of PSC in pediatric patients.