Nervous and Neuroendocrine regulation of the pathophysiology of cholestasis and of biliary carcinogenesis

Figure 1 Proposed working model for the existence of an autocrine/paracrine loop of neuroendocrine hormones and neuropeptides that regulate the proliferative response of cholangiocytes to cholestasis. A chronic cholestatic condition induces cholangiocyte proliferation and their transdifferentiation in neuroendocrine-like cell. This allows the biliary epithelium to start to synthesize and secrete a number of peptides that aim to counterbalance the effects of cholestasis itself on cell growth, as a sort of negative feed-back.