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Curto A, Iamello RG, Lynch EN, Galli A. Advancing the management of primary biliary cholangitis: From pathogenesis to emerging therapies. World J Clin Cases 2025; 13(30): 109028 [PMID: 41113084 DOI: 10.12998/wjcc.v13.i30.109028]
World J Clin Cases. Oct 26, 2025; 13(30): 109028 Published online Oct 26, 2025. doi: 10.12998/wjcc.v13.i30.109028
Advancing the management of primary biliary cholangitis: From pathogenesis to emerging therapies
Armando Curto, Rocco G Iamello, Erica N Lynch, Andrea Galli
Armando Curto, Rocco G Iamello, Erica N Lynch, Andrea Galli, Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence 50134, Tuscany, Italy
Erica N Lynch, Department of Medical Biotechnologies, University of Siena, Siena 53100, Tuscany, Italy
Co-first authors: Armando Curto and Rocco G Iamello.
Author contributions: Curto A and Iamello RG wrote the paper, they contributed equally to this article, they are the co-first authors of this manuscript; Lynch EN performed English language proofreading; Galli A critically revised the manuscript; and all authors approved the final version of the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Erica N Lynch, MD, Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Largo Brambilla 3, Florence 50134, Tuscany, Italy. ericanicola.lynch@unifi.it
Received: April 28, 2025 Revised: May 19, 2025 Accepted: August 11, 2025 Published online: October 26, 2025 Processing time: 166 Days and 15.2 Hours
Core Tip
Core Tip: Primary biliary cholangitis (PBC) is a progressive autoimmune liver disease driven by a complex interplay of genetic, environmental, and microbial factors. Despite advances in early diagnosis and the widespread use of ursodeoxycholic acid, a significant subset of patients experiences incomplete biochemical response and disease progression. This review highlights recent breakthroughs in understanding PBC pathogenesis, the limitations of current therapies, including the withdrawal of obeticholic acid, and the emerging role of novel agents such as selective peroxisome proliferator-activated receptors agonists. Future strategies focusing on early intervention, personalized treatment, and symptom management may reshape the clinical management and prognosis of PBC.
