Appointment of Albert Parés, Group leader
Excellent care cannot be given without research

Current research

Problem

The autoimmune cholestasis diseases, which include primary biliary cholangitis, primary sclerosing cholangitis and autoimmune hepatitis, are rare, but their prevalence is growing. Their development, presentation, course, prognosis and treatment are still little known.

The group’s goal is to improve knowledge of all these aspects, and to address new therapeutic strategies. The group also emphasises better knowledge regarding the origin, development and treatment of manifestations associated with autoimmune cholestasis diseases, such as pruritus and osteoporosis.

Approach

The group analyses the clinical characteristics and the prognostic indicators of these diseases to delimit the subgroup of patients that requires innovative therapies. To find out about the origin and development of pruritus, it conducts metabolomic studies in patients who receive different known treatments or those under evaluation, such as fibrates.

Knowledge of the metabolic pathology of the bone is partially addressed, through experimental procedures with specific bone cell lines. From the clinical point of view, new first- and second-line treatment options are being evaluated to prevent the loss of bone mass and relieve pruritus.

Impact

The group has defined criteria for therapeutic response to ursodeoxycholic acid in primary biliary cholangitis and has described which patients need a second-line treatment (second option).

The group has demonstrated the efficacy of fibrates and their role in pruritus associated with cholestasis. For primary sclerosing cholangitis it has defined several phenotypes and prognostic factors, and for autoimmune hepatitis the group is analysing which patients can stop taking immunomodulators (agents that act on the mechanisms of the immune response).

As regards osteoporosis related to cholestasis, the group has shown that, basically, it depends on impaired bone formation.