Kupffer cell autophagy emerges as a central regulator of immune dysregulation in primary biliary cholangitis

Primary biliary cholangitis (PBC) is a rare chronic autoimmune cholangiopathy that mainly affects middle-aged women, characterised by progressive destruction of the small intrahepatic bile ducts, leading to cholestasis, persistent inflammation and, over time, fibrogenesis. 1 Ursodeoxycholic acid (UDCA) remains the first-line therapy and has significantly improved prognosis through its hepatoprotective and choleretic effects. However, approximately one-third of patients show an inadequate response, with an increased risk of fibrosis progression and cirrhosis, highlighting a substantial unmet therapeutic need.2