Histopathological Study of Primary Biliary Cirrhosis and the Effect of Ursodeoxycholic Acid Treatment on Histology Progression
Open accessAbstract
The semiquantitative histopathological analysis of the liver biopsies obtained before and after 4 years of ursodeoxycholic acid (UDCA) therapy in a cohort of primary biliary cirrhosis (PBC) patients is reported. The relationships between elementary histological lesions before treatment and their progression under therapy were assessed. At baseline, two independent groups of lesions, each of which participate in the development of fibrosis, were individualized, i.e., florid bile duct lesions and ductopenia on one hand and lymphocytic piecemeal necrosis, ductular proliferation, and lobular necroinflammatory changes on the other hand. Four years of UDCA therapy were associated with a significant decrease in the prevalence of florid interlobular bile duct (ILBD) lesions, of epithelioid granuloma (P < .001) without any aggravation in the severity of bile duct paucity. Lobular inflammation and necrosis markedly improved (P < .001) whereas the degree of severity of the lymphocytic piecemeal necrosis and ductular proliferation at entry and at 4 years were similar. Worsening of fibrosis was observed in 14 patients (12 of them had a one grade progression) whereas stabilization was noted in 30 of the remaining patients. Severity of both the lymphocytic piecemeal necrosis and lobular inflammation and necrosis at entry was significantly associated with the progression of fibrosis. The results suggest that UDCA therapy influences the process leading to bile duct destruction. Patients with severe lymphocytic piecemeal necrosis and lobular inflammation may need additional therapeutic intervention because they have increased risk of fibrosis progression
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
UDCA therapy does not improve fatigue, pruritus, associated bone disease, or autoimmune features found in association with PBC.
“However, UDCA therapy does not improve fatigue, pruritus, associated bone disease, or autoimmune features found in association with PBC.(69,89,153,154)”
From Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases (2019) · cites this paper as [89]
The paper’s ‘Effect of UDCA Therapy on Histological Progression’ and ‘UDCA Therapy and Histology Progression’ sections assess liver-biopsy findings, not whether UDCA improves fatigue, pruritus, bone disease, or associated autoimmune features. Searches for those symptoms and conditions found no passage addressing the claimed lack of improvement; page numbers were not supplied for the passages. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 20 · Cited by 174
Research works printed but not linked: 18
- Poupon RE, Balkau B, Eschwe `ge E, Poupon R, and the UDCA-PBC Study Group. A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis. N Engl J Med 1991;324:1548-1554.
- Lindor KD, Dickson ER, Baldus WP, Jorgensen RA, Ludwig J, Murtaugh P, Harrison JM, et al. Ursodeoxycholic acid in the treatment of primary biliary cirrhosis. Gastroenterology 1994;106:1284-1290.
- Heathcote EJ, Cauch-Dudek K, Walker V, Bailey RJ, Blendis LM, Ghent CN, Michieletti P, et al. The Canadian multicenter double-blind random- ized controlled trial of ursodeoxycholic acid in primary biliary cirrhosis. HEPATOLOGY 1994;19:1149-1156.
- Combes B, Carithers R, Maddrey WC, Li D, McDonald MF, Wheeler DE, Eidenbdrot EH, et al. A randomized, double-blind, placebo-controlled trial of ursodeoxycholate in primary biliary cirrhosis. HEPATOLOGY 1995;22:759-766.
- Lehman EL. In: Nonparametrics. New York: McGraw-Hill International Book Company, 197:233. HEPATOLOGY Vol. 29, No. 4, 1999
- DEGOTT ET AL. 1011 15273350, 1999, 4, Downloaded from https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.510290444 by Test, Wiley Online Library on [20/08/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License · DOI
- Portmann B, Popper H, Neuberger J, Williams R. Sequential and diagnostic features in primary biliary cirrhosis based on serial histologic study in 209 patients. Gastroenterology 1985;88:1777-1790.
- Christensen E, Crowe JP, Doniach D, Popper H, Ranek L. Rode ´s J, Tygstrup N, et al. Clinical pattern and course of disease in primary biliary cirrhosis based on an analysis of 236 patients. Gastroenterology 1980;78:236-246.
- Desmet VJ. Vanishing bile duct disorders. In: Boyer JL, Ockner R, eds. Progress in Liver Diseases. Philadelphia: Saunders 1992:89-121.
- Locke GR III, Therneau TM, Ludwig J, Dickson ER, Lindor KD. Time course of histological progression in primary biliary cirrhosis. HEPATOL- OGY 1996;23:52-56.
- Poupon RE, Chre ´tien Y, Poupon R, Paumgartner G. Serum bile acids in primary biliary cirrhosis: effect of ursodeoxycholic acid therapy. HEPATOL- OGY 1993;17:599-604.
- Van Nieuwkerk CMJ, Oude Elferink RPJ, Groen AK, Ottenhoff R, Tytgat GNJ, Dingemans KP, Van den Bergh Weerman MA, et al. Effects of ursodeoxycholate and cholate feeding on liver disease in FVB mice with disrupted mdr2 P-glycoprotein gene. Gastroenterology 1996;111:165- 171.
- Koga H, Sakisaka S, Ohishi M, Sata M, Tanikawa K. Nuclear DNA fragmentation and expression of Bcl-2 in primary biliary cirrhosis. HEPATOLOGY 1997;25:1077-1084.
- Saeki R, Ogino H, Kaneko S, Unoura M, Kobayashi K. Effects of chenodeoxycholic and ursodeoxycholic acids on interferon-␥ produc- tion by peripheral blood mononuclear cells from patients with primary biliary cirrhosis. J Gastroenterol 1995;30:739-744.
- Tanaka H, Makino Y, Miura T, Hirano F, Okamoto K, Komura K, Sato Y, et al. Ligand-independent activation of the glucocorticoid receptor by ursodeoxycholic acid. Repression of IFN-␥-induced MHC class II gene expression via a glucocorticoid receptor-dependent pathway. J Immunol 1996;156:1601-1608.
- Joplin R, Lindsay JG, Johnson GD, Strain A, Neuberger J. Membrane dihydrolipoamide acetyltransferase (E2) on human biliary epithelial cells in primary biliary cirrhosis. Lancet 1992;339:93-94.
- Leung PSC, Van de Water J, Coppel RL, Nakanuma Y, Munoz S, Gershwin ME. Molecular aspects and the pathological basis of primary biliary cirrhosis. J Autoimmun 1996;9:119-128.
- Chazouille `res O, Wendum D, Serfaty L, Montembault S, Rosmorduc O, Poupon R. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: clinical features and response to therapy. HEPATOLOGY 1998; 28:296-301.
- Authors
- Degott, C., Zafrani, E. S., Callard, P., Balkau, B., Poupon, R. E., & Poupon, R.
- Affiliations
- Hôpital Beaujon (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Inserm (FR)
- Corresponding author
- Poupon, Raoul
- Venue
- Hepatology
- Published
- 1999-04
- Volume
- 29
- Issue
- 4
- Pages
- 1007-1012
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2024183286
- Cited by
- 174
- References
- 20
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 10 · 2017: 4 · 2016: 5 · 2015: 6 · 2014: 10 · 2013: 4 · 2012: 5
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Keywords
- primary biliary cirrhosis, ursodeoxycholic acid, histopathology, liver fibrosis progression, bile duct paucity, epithelioid granulomas, ductular proliferation, lobular inflammation, necroinflammation, bile duct destruction
- MeSH terms
- Bile Ducts, Biopsy, Cholagogues and Choleretics, Double-Blind Method, Humans, Liver Cirrhosis, Biliary, Prognosis, Ursodeoxycholic Acid, Cohort Studies, Treatment Outcome, Disease Progression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
