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Cholestasis

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Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).

Also Known As:

Bile Duct Obstructions; Biliary Stases; Cholestases; Duct Obstruction, Bile; Duct Obstructions, Bile; Obstruction, Bile Duct; Obstructions, Bile Duct; Stases, Biliary; Stasis, Biliary; Bile Duct Obstruction; Biliary Stasis

Networked: 5369 relevant articles (295 outcomes, 478 trials/studies)

Relationship Network

Disease Context: Research Results

Digestive System Diseases: 46
- Biliary Tract Diseases: 336
  - Bile Duct Diseases: 62
    - Cholestasis: 5369

Related Diseases

1.	Pruritus (Itching)
2.	Liver Diseases (Liver Disease)
3.	Biliary Liver Cirrhosis (Primary Biliary Cirrhosis)
4.	Necrosis
5.	Intrahepatic Cholestasis

Experts

1.	Trauner, Michael: 53 articles (09/2015 - 01/2002)
2.	Fickert, Peter: 26 articles (09/2015 - 01/2002)
3.	Alpini, Gianfranco: 25 articles (06/2014 - 05/2002)
4.	Beuers, Ulrich: 24 articles (06/2014 - 05/2004)
5.	Roma, Marcelo G: 24 articles (03/2014 - 04/2002)
6.	Boyer, James L: 23 articles (12/2015 - 08/2002)
7.	Glaser, Shannon: 23 articles (04/2015 - 05/2002)
8.	Francis, Heather: 21 articles (06/2014 - 05/2002)
9.	Wagner, Martin: 20 articles (09/2015 - 09/2003)
10.	Marin, Jose J G: 19 articles (02/2015 - 09/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Cholestasis:

1.	Ursodeoxycholic Acid (Urso)FDA LinkGeneric 01/01/2006 - "We have investigated whether maternal obstructive cholestasis during pregnancy (OCP) causes oxidative stress and apoptosis in rat placenta and whether treatment with ursodeoxycholic acid (UDCA, i.g., 60 microg/100 g b.wt./day, following complete biliary obstruction on day 14 of pregnancy) has protective effects on this organ. " 03/01/2003 - "Cholestasis and liver function tests improved significantly during treatment with ursodeoxycholic acid (750 mg per day). " 12/01/1997 - "[Successful therapy of persistent androgen-induced cholestasis with ursodeoxycholic acid]." 03/01/2000 - "These cases suggest that ursodeoxycholic acid may be an effective treatment for drug-associated cholestasis." 10/01/1995 - "In an uncontrolled series of three patients with cholestasis of pregnancy, ursodeoxycholic acid seemed to provide safe and effective therapy."
2.	BilirubinIBA 01/01/1997 - "The results showed a significant reduction in the measured gallbladder area in group II alcoholics, but not in patients of group I. Furthermore, three weeks of treatment with Pergoli water significantly reduced to normal total and direct bilirubin levels, the enzyme markers of biliary stasis and the subjective sensation of itch. " 08/01/1999 - "The measurement of CB in blood is superior to the measurement of direct bilirubin because an abnormal concentration of direct bilirubin does not necessarily indicate the presence of cholestasis." 12/01/1980 - "In one patient, it was observed that continuous PTCD over three weeks was effective in reducing serum bilirubin by relief of cholestasis. " 12/01/2006 - "Cholestasis and levels of bilirubin improved over time. " 02/01/1980 - "The hepatic clearance of unconjugated radiobilirubin was normal at all times in this patient, although during cholestasis, conjugated bilirubin reflexed from the liver to the plasma and was then cleared slowly with a half life of approximately 12 hours. "
3.	Bile Acids and Salts (Bile Acids)IBA 01/01/2010 - "These findings indicate that loss of Ostalpha provides protection from liver injury in obstructive cholestasis through adaptive responses in both the kidney and liver that enhance clearance of bile acids into urine and through detoxification pathways most likely mediated by the nuclear receptor Car." 01/01/2013 - "Therapeutic approaches that target Mfn2 may have protective effects against hepatotoxic of bile acids during cholestasis." 12/01/2013 - "The use of UDCA in patients with cholestasis would be benefited because of the protective effect on the intestinal Ca(2+) absorption, avoiding the inhibition caused by hydrophobic bile acids and neutralizing the oxidative stress." 01/01/2003 - "The results demonstrate that there is a functional adaptive downregulation of renal tubular bile acid transport enhancing renal clearance of bile acids during the early phase of an obstructive cholestasis." 03/24/1989 - "These findings indicate that altered metabolism, such as 1 beta- or 6 alpha-hydroxylation of bile acids, is enhanced in cholestasis, and that the resulting hydroxylated metabolites are eliminated in the urine."
4.	EnzymesIBA 11/01/2011 - "Remission of cholestasis occurred at a median age of 65 days, whereas liver enzymes occurred at 90 days. " 01/01/1982 - "[Clinical and experimental studies of membrane bound enzymes in cholestasis (author's transl)]." 04/01/1979 - "The rise of the activity of the enzymes under study within the first days after operation and its normalization by the 7th to 14th days in all the studied variants of hemo- an cholestasis have been established." 01/01/1974 - "Histochemical studies of hepatic enzymes in dogs subjected to lobar bile duct obstruction." 07/01/1973 - "Histochemical study of so-called "marker enzymes of cholestasis" during extrahepatic bile duct obstruction in the rat."
5.	Rifampin (Rifampicin)FDA LinkGeneric 08/16/2012 - "Rifampicin was effective in treating cholestasis. " 03/18/1989 - "Both drugs were equally effective in inducing hepatic microsomal function but rifampicin has the additional effect of reducing cholestasis. " 09/01/2011 - "This study evaluated the effect of rifampicin on the expression of different detoxification systems and bile acid transporters during in-vivo and in-vitro experimental models of cholestasis. " 10/01/2009 - "The aim of this study was to characterize the expression and localization of hepatocyte tight junctions in rifampicin-induced cholestasis in mice. " 10/22/2004 - "Consistent with these studies, the antibiotic rifampicin, a ligand for human PXR, reduces hepatic bile acid levels in cholestasis patients. "
6.	Biological Markers (Surrogate Marker)IBA 01/01/2001 - "Multicenter randomised controlled trials proved that the treatment is associated with a marked improvement in serum biochemical markers of cholestasis, i.e. " 04/01/2013 - "One-directed affirmative action study drugs, shown to reduce the level of biochemical markers of cytolysis and cholestasis in conjunction with a significant reduction in symptoms of fatty, hyaline droplet and hydropic degeneration. " 12/01/2013 - "Administration of Heptral in patients with NALD and IHC resulted in significant improvement in burden of disease, laboratory markers, signs and symptoms of cholestasis. " 09/01/2006 - "Improvement in symptoms was associated with a significant improvement in biochemical markers of cholestasis. " 04/01/2000 - "This therapy also causes a significant improvement of all the biochemical markers of cholestasis but has no beneficial effects on any of the symptoms or associated disorders. "
7.	1-phenyl-3,3-dimethyltriazene (PDT)IBA 09/01/2010 - "Several studies conducted in Europe and the United States have shown that PDT produces a marked improvement in the symptoms of cholestasis, survival, and quality of life. " 05/01/2005 - "However, PDT leads to a significant reduction of cholestasis. " 06/01/2013 - "Four patients showed a tumoricidal depth of ≥7.5 mm. Cholestasis and palliation improved in 8 patients with an overall median survival of 18 (4.4-32.0) months after the first T-PDT. " 08/01/2006 - "In a randomized trial of patients with nonresectable cholangiocarcinoma, PDT prolonged survival time, improved cholestasis and quality of life considerably, and had a favorable side-effect profile. " 10/01/2014 - "Photodynamic therapy (PDT) is a new therapeutic approach for the palliative treatment of malignant bile duct obstruction. "
8.	CholesterolIBA 01/01/2012 - "Its introduction in the combined treatment of NACH increased functional capacity of the liver by decreasing the severity of cytolysis, cholestasis, hepatomegalia, and steatosis (ultrasonic study), improved lipid metabolism, reduced cholesterol level, triglyceridemia, and atherogenic index. " 06/01/1986 - "Since microtubules play an important role in the intracellular transport of many materials, including cholesterol, the present study was undertaken to assess the extent to which they participate in the development of LCA-Na-induced cholestasis. " 02/01/2015 - "The systemic expression of the bile acid (BA) sensor farnesoid X receptor (FXR) has led to promising new therapies targeting cholesterol metabolism, triglyceride production, hepatic steatosis and biliary cholestasis. " 03/01/2013 - "The total cholesterol normalized on improvement of his cholestasis." 05/01/2012 - "Despite the fact that results from preclinical models are encouraging, targeting FXR holds potential for side effects (i.e., impaired cholesterol disposal and cholestasis). "
9.	Alkaline PhosphataseIBA 01/22/1996 - "Treatment-related decreases in alkaline phosphatase activity occurred, however, in 39-56% of the studies; serum alkaline phosphatase may be more useful as an indicator of decreased food intake (decreased activity) than of cholestasis (increased activity). " 01/01/1982 - "Studies on the mechanism of the increase in serum alkaline phosphatase activity in cholestasis: significance of the hepatic bile acid concentration for the leakage of alkaline phosphatase from rat liver." 09/01/2015 - "Serum alkaline phosphatase levels accurately reflect cholestasis in mice." 05/01/2007 - "Elevation of hepatic aminotransferase and alkaline phosphatase with cholestasis was common." 01/19/2006 - "Laboratory findings of elevated alkaline phosphatase and gamma-GT indicate the presence of cholestasis. "
10.	Taurine FDA Link 01/01/1992 - "Taurine therapy is recommended, because it might be effective for treating neonatal cholestasis." 12/01/1992 - "Although simultaneous addition of UDCA also showed slight improvement, with or without taurine pre-treatment, biliary bile-salt analysis also showed that cholestasis was markedly remitted as the excretion of taurine-conjugated UDCA was increased. " 11/01/2012 - "These results show Taurine's hepatoprotective effect and support its use in cases of TPN-induced cholestasis. " 10/01/2005 - "Taurine and cholestasis associated to TPN. " 05/01/2003 - "The data show that oral supplementation of taurine induces Mrp2 and Bsep expression and may prevent LPS-induced cholestasis."

Therapies and Procedures

1.	Parenteral Nutrition 02/01/2008 - "Cholestasis remains an important complication of parenteral nutrition, and several clinical and biochemical factors may be helpful in identifying high-risk patients." 05/01/2007 - "Although it has been more than a quarter of a century since parenteral nutrition was first introduced and its association with hepatic complications described, the precise etiology of parenteral nutrition associated cholestasis (PNAC) remains a mystery; however, our understanding of the molecular components that contribute to PNAC has improved substantially. " 03/01/1999 - "Although Vit E-supplemented parenteral nutrition was effective in preventing the development of cholestasis in the 10-day group (p < 0.05), it was not effective in the 20-day group when compared with incidence of cholestasis in the parenteral nutrition-only group (p > 0.05). " 05/07/2015 - "The authors have shown from explant livers of children on chronic parenteral nutrition with Omegaven™ that biochemical improvement in cholestasis does not always reflect improvement in liver histology. " 06/01/2010 - "In several animal models of PNALD, the use of an intravenous fish oil-based lipid emulsion improved parenteral nutrition-associated cholestasis without resultant essential fatty acid deficiency or growth impairment. "
2.	Ligation 08/27/1997 - "These results suggest that UR-906 has a beneficial effect against cholestasis induced by bile duct ligation in rats and that this drug may be useful in the treatment of clinical cholestatic disorders." 01/01/2013 - "The aim of the present study was to evaluate the protective effects of PD on bile duct ligation (BDL)-induced cholestasis in mice. " 01/01/1994 - "A reduced efficacy of VIP (43% of the control) without modification in its potency (ED50 = 2.2 nM) was observed in regenerating rat liver after cholestasis (bile duct ligation). " 07/01/2015 - "The study examined the global metabolic and some biochemical changes in rats with cholestasis induced by bile duct ligation (BDL). " 11/07/2011 - "A rat model of cholestasis induced by bile duct ligation (BDL) was used for the study. "
3.	Aftercare (After-Treatment) 08/01/1999 - "One month after treatment, there was a significant improvement in the cholestasis indicating parameters in all Fasciola cases compared to the pretreatment ones. " 01/01/2007 - "In rats treated once with ANIT (75 mg/kg, i.p.), liver injury with cholestasis occurred 24 h after treatment and progressed at 48 h. " 01/01/2007 - "Before therapy, the hepatic cholestasis was present in 20 patients (54.05%), and after treatment in 14 patients (37.83%). " 07/01/2006 - "The distinction between these 2 diseases has prognostic implications: idiopathic cholestasis is usually reversible in early-stage HL after treatment, whereas patients who develop VBDS commonly die from their disease. " 09/01/1999 - "One patient developed biochemical cholestasis the third day after treatment, but her enzyme profiles returned to normal after 2 months. "
4.	Liver Transplantation 06/21/2015 - "However, cholestasis and abnormal laboratory indices persisted, and the infant died at the age of 11.5 mo, two days before a scheduled liver transplantation. " 01/01/2015 - "Treatment was discontinued but our patient's condition was aggravated by severe cholestasis and grade III/IV encephalopathy, requiring liver transplantation. " 09/01/2013 - "An unusual cause of cholestasis after liver transplantation. " 03/01/2013 - "In unclear cholestasis after liver transplantation SSC has to be considered as the underlying cause." 02/01/2013 - "Thus, the most important criterion for liver transplantation in neonatal PIBD is intractable cholestasis. "
5.	Photochemotherapy (Photodynamic Therapy) 03/01/1998 - "The aim of this study was to evaluate the effect of photodynamic therapy on cholestasis, quality of life, and survival in these patients. " 10/18/2006 - "Photodynamic therapy, a light therapy, is the first approach leading to an improvement of cholestasis and quality of life as well as to a prolongation of survival time. " 08/17/2000 - "Preliminary data of photodynamic therapy in bile duct cancer show good results concerning reduction of cholestasis, improvement of life quality and even prolongation of survival time. " 05/01/2004 - "A randomised trial comparing photodynamic therapy plus endoprostheses insertion versus endoprostheses insertion alone, indicates a considerably benefit on survival time, cholestasis and quality of life in large, advanced cholangiocarcinoma. " 04/01/2014 - "Whereas stents alone can help achieve relief of bile duct obstruction, endoscopic ablative interventions with photodynamic therapy or radiofrequency ablation are also useful in destroying intraluminal tumor. "