Immunosuppressive therapy for primary biliary cirrhosis

The studies described in this thesis focus on three items: a. The possible role of CyA in the treatment of PBC. Firstly, we tried to find out whether CyA is effective in treating PBC, which dose would be appropriate and whether there is a subgroup of PBC patients that would particularly benefit from CyA therapy (chapter II). Secondly, we investigated whether the efficacy of CyA in the treatment of PBC could be enhanced by selecting patients on the basis of data from the first study and by adding a low dose of prednisone (chapter Iii). Finally - because CyA is metabolized almost entirely in the liver - we studied the pharmacokinetics of the drug in patients with non-endstage PBC and a control group of patients with a presumably normal liver, in this case patients with skin diseases (chapter IV).b. The extent of metabolic bone disease and the possible role of corticoste- 25 roid therapy in our patients with PBC (chapter V). c. The value of type Ill procollagen amino propeptide as a predictor for progressive disease. Looking for a parameter that would indicate which patients wil! deve[op progressive disease we retrospectively studied the levels of the precursor peptide of coHagen type Ill, i.e. the aminoterminai procoflagen peptide type Ill (PiliP), in patients with histologically progressive disease compared with those with non-progressive early disease (chapter VI).