G. Paumgartner - Böcker

Since the last International Bile Acid Meeting in San Diego in 1994, advances have been made in the understanding of bile acid metabolism and transport. The cytotoxic as well as the therapeutic effects of specific bile acids have been further explored and the beneficial effects of ursodeoxycholic acid in various chronic cholestatic conditions have been substantiated. Much basic and clinical research has been conducted to unravel the underlying mechanisms of action. This volume, the proceedings of Falk Symposium 93 (XIV International Bile Acid Meeting), held in Freiburg-im-Breisgau, Germany, October 22-24, 1996, is dedicated to both basic and clinical aspects of bile acid research related to the role of bile acids in hepatobiliary diseases.

Knowledge about the cell biology of the cholangiocytes and the function of the bile ducts has increased considerably. Their role in liver diseases is increasingly recognized. As a consequence, important progress has been made not only in the pathogenesis and pathophysiology but also in the diagnosis and treatment of biliary liver diseases. This book, the proceedings of the Falk Symposium 107 on "Diseases of the Liver and the Bile Ducts, New Aspects and Clinical Implications", held in Prague, Czech Republic, on 30 April - 2 May, 1998, brings together scientists and clinicians to highlight advances in molecular biology, physiology, diagnosis and therapy of diseases of the biliary system. World experts cover a broad spectrum of topics from genetic tests to endoscopy and from medical treatment to liver transplantation.

In 1992, the Falk Symposium No. 70 dealt with the topic "Immunology and Liver". At that time, basic mechanisms of immunology as well as immunopathogenetic mechanisms in viral and autoimmune liver diseases were discussed. Seven years later, the Falk Symposium No. 114, held in Basel, Switzerland, October 20-21 1999 (Part I of the Basel Liver Week 1999), focused on immunology in autoimmune liver diseases. In the first section of this text, basic mechanisms of autoimmunity are presented, including the relevance of superantigens and the role of apoptosis. A further topic is the latest developments concerning animal models for autoimmune diseases. Drug- and hepatitis-virus induced immune mediated liver diseases may serve as models for nonhepatic immune mediated disorders. DNA technology has increased our knowledge of the immunogenetic background of autoimmune liver diseases. Among the cholestatic immune mediated liver diseases, significant progress has been made concerning primary biliary cirrhosis, in particular regarding the identification of mitochondrial antigens and the characterization of the immune reactions directed at them.The involvement of infectious agents in PBC as well as the definition of overlap syndromes is a particular focus for basic and clinical research in this area. Concerning the therapy of autoimmune liver diseases, corticosteroids and azathioprin remain the state of the art for autoimmune hepatitis, while bile acids have become well established in treatment of primary biliary cirrhosis as well as primary sclerosing cholangitis. New drugs in the future will include topical steroids such as budesonide and new immunosuppressive agents like mofetil/mycophenolate.

Beginning in 1970, the International Bile Acid Meeting has taken place every two years and each time new progress in our understanding of the complex role of bile acids in many metabolic processes of the liver and the intestine has been revealed by a selected group of leading scientists from all over the world. Although originally mainly physiological data on bile acid synthesis and transport were emphasized, and later on also the therapeutic benefit of bile acids in gallstone disease and cholestasis was discovered, we have come now to the molecular biology and genetic era with major discoveries in transport defects and related diseases. This book is the proceedings of Falk Symposium No. 120, held in The Hague, The Netherlands, on October 12-13, 2000 - the 16th International Bile Acid Meeting. One of the main discoveries recently has been the identification of nuclear receptors for bile acids, which gives them a much broader perspective than previously anticipated. It even suggests that bile acids can regulate their biosynthesis and enterohepatic circulation transcriptionally. It will therefore not be surprising that this topic, together with the molecular regulation of cholesterol 7alpha-hydroxylase and cholesterol homeostasis, has a dominant place in these proceedings. Another important topic is the progress in our molecular understanding of hepatic (both at the basolateral and canalicular sites), cholangiocytic and intestinal bile acid transport processes. Further insights into genetic defects causing cholestasis or intestinal malabsorption in animal models and in human diseases are also discussed by a number of well-known authors. Finally the last section deals with new findings on the role of bile acid therapy in cholestatic syndromes or chemoprevention and with the potential benefit of bile acid inhibitors. All contributors provide an update on the most recent developments in their field.

In recent years, our knowledge about the pathogenesis, pathophysiology and treatment of hepatobiliary diseases has increased considerably. The molecular basis of cholestatic disorders as well as of gallstone disease is increasingly recognized. This has resulted in improved diagnosis, for instance in hereditary forms of intrahepatic cholestasis, and advances in treatment, for example in primary biliary cirrhosis and other chronic cholestatic disorders. This book, the proceedings of a Falk Workshop held in Cluj-Napoca, Romania, on June 9-10, 2000, brings together contributions from scientists and clinicians to highlight the most recent advances in molecular biology, pathophysiology, diagnosis and therapy of diseases of the hepatobiliary system. World experts cover a broad spectrum of topics from genetic studies to endoscopy and from medical treatment to liver transplantation.

Since the International Bile Acid Meeting in The Hague in 2000, bile acid research has continued to flourish and therapeutic use of bile acids has attained a broader role. Bile acid research has been stimulated by the discovery that bile acids specifically bind to receptors of the cell nucleus. Thereby, they regulate the transcription of transport proteins and enzymes involved in synthesis, transport and metabolism of bile acids and maintain cholesterol homeostasis. Knowledge about genetic defects of bile acid transport which may cause cholestasis or intestinal malabsorption has also increased impressively. Therapy of chronic cholestatic liver diseases, especially of primary biliary cirrhosis, with ursodeoxycholic acid represents an important advance in modern hepatology and has stimulated basic and clinical research to unravel the underlying mechanisms of action and to optimize treatment schedules.This book is the proceedings of Falk Symposium 129, the XVII International Bile Acid Meeting held in Freiburg, Germany, May 30-June 1, 2002, which was again dedicated to both basic and clinical aspects of bile acid research, with a focus on the role of bile acids in hepatobiliary and intestinal diseases. The most up-to-date findings are presented by leading scientists and clinicians in the field.

This work contains the proceedings of the 13th International Bile Acid Meeting (Falk Symposium 80), an official satellite meeting of the World Congress of Gastroenterology, held in San Diego, California, USA, September 30 - October 2, 1994. It begins with presentations of major advances in bile acid chemistry, biology and pharmacology. The new structure proposed for the mixed micelles present in bile is reviewed, as are the properties of new synthetic analogues of bile acids. The mechanisms by which bile acids interact with cell membranes are discussed in order to provide insight into the hepatotoxic effects of bile acids in cholestatic liver disease. The book further shows the progress in the molecular biology of bile acid transport by the hepatocyte and enterocyte, and concludes with a consensus on the use of ursodeoxycholic acid in cholestatic liver disease and as an adjunct to immunosuppressive therapy after liver transplantation, and to interferon therapy in chronic viral hepatitis.

Bile acid research has attracted increasing attention from both basic scientists and clinical hepatologists over the last decade. Experimental studies have expanded our knowledge of the role of bile acids in liver disease, and well-designed clinical trials have documented beneficial effects of bile acid treatment for a number of hepatobiliary diseases. These proceedings of an International Falk Workshop held in Munich, January 1995, provide insights into concepts in bile acid chemistry, bile acid synthesis and metabolism, and transport of bile acids across the hepatocyte. The role of bile acids in bile formation, cholestasis and hepatotoxicity are discussed. Finally, the book addresses experimental studies and hypotheses about the putative mechanisms of action of ursodeoxycholic acid in cholestatic liver diseases, and summarizes the clinical applications of bile acid treatment on the basis of controlled clinical trials.

This book reflects the recent progress in bile acid metabolism and transport, nuclear receptor regulation and signaling by bile acids, as well as mechanisms of bile acid-induced cellular injury. Coverage examines bile acids as therapeutic agents, particularly for the treatment of cholestatic liver diseases. This volume in the Falk Symposium series brings together basic science and clinical hepatology in the field of bile acids.