M.P. Manns – författare

Primary sclerosing cholangitis is a chronic disease of the intra and extrahepatic bile ducts leading to obstructions and dilatations followed by liver cirrhosis and in some cases cholangiocarcinoma. In 50% of cases primary sclerosing cholangitis is associated with inflammatory bowel disease. The cause of the disease is unknown and many questions concerning the pathogenesis still remain open. In recent years our knowledge of the natural course, the risk of cholangiocarcinoma and the possibility of medical, endoscopic and surgical treatment has increased. Ursodeoxycholic acid, endoscopic treatment and liver transplantation have become standard therapeutic procedures. This book is the proceedings of the Falk Workshop held on October 3, 1997, in Freiburg, Germany (Part II of the Liver Week Freiburg 1997), and covers the most important aspects of this disease.

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.

The last years of the 20th century saw an increasing need for transplantation, but the number of donor livers available increased only slightly, despite intensive public relations activities. Alternative concepts in the field of transplantation, for instance the transplantation of living donor organs or the splitting of organs, are urgently required, to safeguard the treatment of patients with severe liver disease. The development and clinical application of cell therapy for patients with liver disease could present a significant enhancement of the therapeutic options. The aim of such cell therapy is to repair or improve the biological function of the chronically and acutely damaged liver. Even though systematic trials are not available, individual case reports and small series already show promising clinical results. Concepts of cell therapy for liver diseases based on the use of primary hepatocytes have recently been considerably extended through new data on the biology of stem cells. The adult haematopoetic stem cell as a pool for hepatocyte grafts - what would be the perspectives for the clinical application? This book is the proceedings of the Falk Symposium No.126 on "Hepatocyte Transplantation" (Progress in Gastroenterology and Hepatology Part III) held in Hannover, Germany, October 2-3, 2001, and is a forum for basic research, but also for questions concerning clinical applications in the field of hepatocyte transplantation.

This book is the proceedings of the Falk Symposium No. 135 held in Prague, Czech Republic, on September 12-13, 2003, and is dedicated to the important issue of immunological aspects of diseases of the liver and gut. Without any doubt, immunological pathways are among the most important and universal factors in the pathogenesis of all diseases. Their importance is also constantly increasing, because these principles have been adopted in clinical practice for both diagnostic and therapeutic procedures. Chapters by prominent experts will stimulate new ideas and set the scene for productive discussion on this topic.

This book is the proceedings of the Falk Symposium No. 138 on "State of the Art of Hepatology: Molecular and Cell Biology" (part of the XII International Falk Liver Week 2003 in honour of Hans Popper’s 100th birthday, held on October 20--11, 2003), and reflects the tremendous advances in the science of hepatology both at the molecular as well as the cellular level. The book comprises four major sections. In Section I, the basic aspects of liver cell biology are covered, including RNA metabolism, regeneration, transport and metabolic functions, as well as fibrogenesis and malignant transformation. In Section II, the novel field of stem cell plasticity and cell therapy for liver diseases is discussed in detail, including stem cell biology, hepatocyte transdifferentiation from extrahepatic stem cells and their therapeutic use for liver cell repopulation, as well as hepatocyte transplantation. In Section III, novel therapeutic strategies for liver cirrhosis and hepatocellular carcinoma are presented, including the reversal of liver fibrosis, oncolytic biotherapy and different concepts of gene therapy for hepatocellular carcinoma. In Section IV, novel aspects of gene therapy and prevention of liver diseases are addressed, including small interfering RNAs, ribozymes, antisense oligonucleotides, as well as DNA vaccination. An international faculty of outstanding scientists from different research areas presents the state of the art on these most important aspects of hepatology and their perspectives for future developments. Molecular and cell biology are at the very centre of research developments in modern hepatology and are of interest and importance to both basic scientists as well as clinicians involved in patient care.

In several liver diseases, the underlying cause cannot always be eliminated, i.e. the progression of liver disease cannot be prevented. This is particularly true for non-responders to the treatment of chronic hepatitis C (HCV). It is relevant for more than 40% of patients with HCV genotype 1 and up to 20% of patients with genotype 2 or 3. Several approaches are now underway to prevent or ameliorate mechanisms of disease progression. In Asia, and particularly in Japan, Glycyrrhizine-SNMC has been widely used for this purpose. At present, SNMC is under clinical evaluation in Europe.

Das Buch stellt den aktuellen Wissensstand dar, den der praktisch tätige Gastroenterologe in Klinik und Praxis benötigt. Ein Überblick über wichtige Leitsymptome und Notfallsituationen gibt ihm die Möglichkeit, kurz und prägnant Wissen zu akquirieren. Weiterhin kann er sich durch eine gute didaktische Aufbereitung der Kapitel schnell und umfassend zu einzelnen Krankheitsentitäten informieren. Durch die Gliederung in symptomorientierte Sektionen konnten molekulare und zelluläre Grundlagen von Entzündung, Tumorentstehung, Stoffwechsel und Motilität jeweils in einem Kapitel zusammengefasst werden. Der größte Wert wurde auf die ausführliche Beschreibung der klinischen Krankheitsbilder, ihrer Diagnostik und Therapie gelegt. Dabei orientiert sich das Buch and den Themen, die für den in Weiterbildung befindlichen Arzt erforderlich sind.

Das Buch stellt den aktuellen Wissensstand dar, den der praktisch tätige Gastroenterologe in Klinik und Praxis benötigt. Ein Überblick über wichtige Leitsymptome und Notfallsituationen gibt ihm die Möglichkeit, kurz und prägnant Wissen zu akquirieren. Weiterhin kann er sich durch eine gute didaktische Aufbereitung der Kapitel schnell und umfassend zu einzelnen Krankheitsentitäten informieren. Durch die Gliederung in symptomorientierte Sektionen konnten molekulare und zelluläre Grundlagen von Entzündung, Tumorentstehung, Stoffwechsel und Motilität jeweils in einem Kapitel zusammengefasst werden. Der größte Wert wurde auf die ausführliche Beschreibung der klinischen Krankheitsbilder, ihrer Diagnostik und Therapie gelegt. Dabei orientiert sich das Buch and den Themen, die für den in Weiterbildung befindlichen Arzt erforderlich sind.

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. Now, 7 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 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. Recently the International Autoimmune Hepatitis Group newly defined and reclassified the syndrome of autoimmune hepatitis. Autoimmune hepatitis is now identified and studied in all parts of the world, including Asia and South America. A special variant of autoimmune hepatitis was identified as one organ manifestation of the autoimmune polyendocrine syndrome type 1, a genetic disease caused by mutations in a single transcription factor. 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 characterisation 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. Liver transplantation is the treatment of choice for end stage liver diseases; all autoimmune liver diseases are among the best candidates for liver transplantation. Hopefully, new therapeutic strategies based on the results obtained from experimental models will become everyday clinical practice in the next decade. Therefore this symposium concludes with a discussion.