碳酸氢根伞在原发性胆汁性胆管炎发病机制中的作用

原发性胆汁性胆管炎(PBC)是一种自身免疫性疾病。虽然PBC具有自身免疫性疾病的特征,但是免疫抑制剂对其疗效不佳,而熊去氧胆酸等参与调节胆汁酸代谢的药物却具有良好疗效。研究显示PBC患者胆管上皮细胞的碳酸氢根(HCO3-)分泌功能受损,失去HCO3-伞阻挡的胆汁酸进入胆管上皮细胞并介导细胞损伤与凋亡,引发凋亡细胞表达自身抗原并造成免疫损伤。为探究胆管上皮细胞所分泌的HCO3-伞在PBC发病机制中的作用,简述了HCO3-伞的生理功能与产生机制,以及HCO3-分泌的影响因素等,并指出HCO3-分泌减少可能是PBC发病机制的关键环节和潜在治疗靶点。

Role of HCO3- umbrella in the pathogenesis of primary biliary cholangitis

Primary biliary cholangitis(PBC)is an autoimmune disease.Although PBC has the features of autoimmune disease,it has poor response to immunosuppressants and good response to the drugs participating in bile acid metabolism,such as ursodeoxycholic acid.Studies have shown that the bicarbonate secretion of biliary epithelial cells is impaired in PBC patients,and bile acid not blocked by HCO₃^- umbrella enters biliary epithelial cells and mediates their damage and apoptosis,leading to the expression of autoantibodies in apoptotic cells and immunologic injury.In order to explore the role of HCO₃^- umbrella secreted by biliary epithelial cells in the pathogenesis of PBC,this article briefly introduces the physiological function and production mechanism of HCO3-umbrella and the influencing factors for HCO₃^- secretion,and it is pointed out that reduced HCO₃^- secretion may be a key link in the pathogenesis of PBC and a potential therapeutic target.