4.1 Review

Modifier genes in cystic fibrosis-related liver disease

Journal

CURRENT OPINION IN GASTROENTEROLOGY
Volume 35, Issue 2, Pages 88-92

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOG.0000000000000508

Keywords

cholangiopathy; cystic fibrosis; innate immunity; serpina1

Funding

  1. Cystic Fibrosis Patients Association Vaincre la Mucoviscidose, Paris, France

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Purpose of review Cystic fibrosis (CF; OMIM 219700) is caused by variations in the cystic fibrosis transmembrane conductance regulator gene. CF-related liver disease (CFLD) affects approximately one-third of patients with CF, but the severity of CFLD is highly variable. This review provides the latest knowledge in the pathophysiology and CF genetic modifier research in CFLD. Recent findings So far, the only modifier gene validated in CFLD is SERPINA1 (alpha-1-antitrypsin) Z allele. Recent studies support the view that cholangiopathy arising in CF is the result of an ill-adapted innate immune response to endotoxins coming from the intestine and triggering a pro-inflammatory response. Summary The pathophysiology of liver disease remains uncertain and so far, no therapy has proven effective to prevent the progression of CFLD. A better understanding of the pathophysiology and the effect of environmental and non-cystic fibrosis transmembrane conductance regulator genetic influences in the context of CFLD development would help improve management and develop new drug therapies.

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