The Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Section of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA.
Pediatr Pulmonol. 2024 Sep;59 Suppl 1:S98-S106. doi: 10.1002/ppul.26869.
Hepatobiliary complications of Cystic Fibrosis (CF) constitute a significant burden for persons with CF of all ages, with advanced CF liver disease in particular representing a leading cause of mortality. The causes of the heterogeneity of clinical manifestations, ranging from steatosis to focal biliary cholestasis and biliary strictures, are poorly understood and likely reflect a variety of environmental and disease-modifying factors in the setting of underlying CFTR mutations. This review summarizes the current understanding of the pathophysiology of hepatobiliary manifestations of CF, and discusses emerging disease models and therapeutic approaches that hold promise to impact this important yet incompletely addressed aspect of CF care.
囊性纤维化(CF)的肝胆并发症对所有年龄段的 CF 患者来说都是一个重大负担,尤其是晚期 CF 肝病是主要的致死原因。临床表现的异质性原因尚不清楚,从脂肪变性到局灶性胆汁淤积和胆管狭窄不等,可能反映了在潜在的 CFTR 突变背景下各种环境和疾病修饰因素的综合作用。本文总结了 CF 肝胆表现的病理生理学的现有认识,并讨论了新兴的疾病模型和治疗方法,有望对 CF 治疗中这一重要但尚未完全解决的方面产生影响。