Potential Role of Bile Acids in the Pathogenesis and Treatment of PBC

Primary biliary cholangitis (PBC) is a chronic cholestatic disease whose pathogenesis involves a complex interplay of genetic predisposition, environmental triggers, and aberrant activation of the immune system. It is characterized by immune-mediated bile duct injury and chronic intrahepatic cholestasis, which ultimately leads to biliary cirrhosis and even liver failure. Cholestasis is an important pathogenetic feature and pathophysiological alteration of PBC, in which toxicity accumulation, inflammatory activation, fibrosis drive, and immunomodulatory abnormalities combine to drive disease progression. In addition, targeted bile acid (bile acid) therapy has shown therapeutic efficacy in improving liver biochemistry and survival in the majority of patients, and the current first-line therapy for PBC is bile acid therapy, with bile acids thought to play an important role in disease progression and treatment. This review focuses on the potential impact of bile acids in the disease process of PBC and its treatment, and discusses the current state of research with a view to informing further studies in PBC.